Individual provider Active NPI

Lori Catherine Sandoval, MSCCCSLP

  • Speech-Language Pathologist
  • Chesapeake, VA
National Provider Identifier
1023208741
Registry record updated Jul 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
12031094 Issued in VA
Practice address
309 Sweetbay Dr
Chesapeake, VA 23322-3854
Phone
(757) 546-8081
NPI assigned
Jul 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 12031094 VA Primary

Addresses

Primary practice location

309 Sweetbay Dr
Chesapeake, VA 23322-3854

Mailing address

309 Sweetbay Dr
Chesapeake, VA 23322-3854
Phone (757) 546-8081

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12031094VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185753600000",
    "number": "1023208741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 SWEETBAY DR",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233223854",
            "telephone_number": "757-546-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 SWEETBAY DR",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233223854",
            "telephone_number": "757-546-8081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "LORI",
        "middle_name": "CATHERINE",
        "name_prefix": "Ms.",
        "credential": "MSCCCSLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2007-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "12031094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.