Nicholaus Sandoval

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

416 Corson Ave
Modesto, CA 95350-5408

Phone

(209) 521-1805

NPI assigned

May 1, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1093404626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CURTION AVE",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953806408",
            "telephone_number": "209-225-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 CORSON AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505408",
            "telephone_number": "209-521-1805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "NICHOLAUS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-01",
        "last_updated": "2023-05-01",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "securerecords.sanford.html",
            "affiliation": "Y",
            "affiliationName": "Redwood Recovery Center",
            "address_1": "416 Corson Ave",
            "city": "Modesto",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953505408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Esmeralda Garza Sandoval Jr.
• Justin Sandoval
• Maria De Jesus Sandoval, MS.,CCC-SLP
• Mariana Sandoval
• Mickey Sandoval
• Roselyn I Sandoval
• Vanessa Alexandra Sandoval
• Veronica Sandoval, ED.S
• Sandra L Vitale (Pacific Orthotics & Prosthetics)
• Denise Sanford

• Social Worker in Modesto, CA
• Providers in Modesto, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; 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.