Provider Demographics
NPI:1316823396
Name:SOCORRO, RAYMONE GEORGE (CNA)
Entity type:Individual
Prefix:
First Name:RAYMONE
Middle Name:GEORGE
Last Name:SOCORRO
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10932 S 275TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:COWETA
Mailing Address - State:OK
Mailing Address - Zip Code:74429-3474
Mailing Address - Country:US
Mailing Address - Phone:954-945-0442
Mailing Address - Fax:
Practice Address - Street 1:10932 S 275TH EAST AVE
Practice Address - Street 2:
Practice Address - City:COWETA
Practice Address - State:OK
Practice Address - Zip Code:74429-3474
Practice Address - Country:US
Practice Address - Phone:954-945-0442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK106S00000X
OK320722980523376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician