Active NPI
Cynthia Sandoval, M.S. CCC-SLP
- Speech-Language Pathologist
- Orange, CA
National Provider Identifier
1063652808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP 17622
- Practice address
- 1301 W Providence Ave
Orange, CA 92868-3808 - Phone
- (714) 639-4990
- Fax
- (714) 639-2593
- NPI assigned
- Mar 5, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP 17622 | CA | Primary |
Addresses
Primary practice location
1301 W Providence Ave
Orange, CA 92868-3808
Mailing address
1294 Bathport Way
Corona, CA 92881-0999
Phone (951) 347-1691
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP 17622 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260144000000",
"number": "1063652808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1294 BATHPORT WAY",
"city": "CORONA",
"state": "CA",
"postal_code": "928810999",
"telephone_number": "951-347-1691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 W PROVIDENCE AVE",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683808",
"telephone_number": "714-639-4990",
"fax_number": "714-639-2593"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDOVAL",
"first_name": "CYNTHIA",
"name_prefix": "Mrs.",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-05",
"last_updated": "2009-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "SP 17622",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.