Active NPI
Carlos Sandoval
- Mental Health Counselor
- Yakima, WA
National Provider Identifier
1073647210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- RC00052209
- Practice address
- 204 S 60TH Ave
Yakima, WA 98908-3502 - Phone
- (509) 972-1420
- NPI assigned
- Mar 16, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | RC00052209 | WA | Primary |
Addresses
Primary practice location
204 S 60TH Ave
Yakima, WA 98908-3502
Mailing address
PO Box 8331
Yakima, WA 98908-0331
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 |
|---|---|---|---|
| RC00052209 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209340800000",
"number": "1073647210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8331",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989080331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 S 60TH AVE",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989083502",
"telephone_number": "509-972-1420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDOVAL",
"first_name": "CARLOS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-16",
"last_updated": "2008-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "RC00052209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yakima, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.