Individual provider Active NPI

Nancy Sandoval-Morton

  • Clinical Social Worker
  • Fairfield, CA
National Provider Identifier
1013491505
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
75514 Issued in CA
Practice address
490 Chadbourne Rd Ste A155
Fairfield, CA 94534-9613
Phone
(925) 529-4978
NPI assigned
Sep 20, 2018
Last updated
Sep 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 75514 CA Primary

Addresses

Primary practice location

490 Chadbourne Rd Ste A155
Fairfield, CA 94534-9613

Mailing address

490 Chadbourne Rd Ste A155
Fairfield, CA 94534-9613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241014004289 CA Practitioner - Clinical Social Worker 4789116872 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
75514CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Clinical CurrentSince Sep 11, 2024 Accepting new patients
Silver Lake Psychology Inc. CurrentSince Jun 3, 2025 Accepting new patients

Locations

2301 Hyperion Ave
#A
Los Angeles, CA 90027
Phone (310) 726-3890

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1013491505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 CHADBOURNE RD STE A155",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945349613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 CHADBOURNE RD STE A155",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945349613",
            "telephone_number": "925-529-4978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL-MORTON",
        "first_name": "NANCY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-20",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "75514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.