Active NPI
Bianca Sandoval
- Marriage & Family Therapist
- Costa Mesa, CA
National Provider Identifier
1043978604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 146125
- Practice address
- 2801 Bristol St
Costa Mesa, CA 92626-5996 - Phone
- (714) 850-8463
- NPI assigned
- Dec 1, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 146125 | CA | Primary |
Addresses
Primary practice location
2801 Bristol St
Costa Mesa, CA 92626-5996
Mailing address
2801 Bristol St
Costa Mesa, CA 92626-5996
Phone (714) 850-8463
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
| License | State | Type | Specialty |
|---|---|---|---|
| 146125 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713225600000",
"number": "1043978604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 BRISTOL ST",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926265996",
"telephone_number": "714-850-8463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 BRISTOL ST",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926265996",
"telephone_number": "714-850-8463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDOVAL",
"first_name": "BIANCA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-01",
"last_updated": "2024-04-16",
"certification_date": "2024-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "146125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.