Sam L Bansal

Primary specialty

Forensic PsychologistTaxonomy code 103TF0200X

Practice address

667 Fairhaven Cir
Porterville, CA 93257-2025

Phone

(805) 712-1023

Fax

(559) 781-1023

NPI assigned

Nov 22, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1385078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1104256478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 FAIRHAVEN CIR",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932572025",
            "telephone_number": "805-712-1023",
            "fax_number": "559-781-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 FAIRHAVEN CIR",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932572025",
            "telephone_number": "805-712-1023",
            "fax_number": "559-781-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANSAL",
        "first_name": "SAM",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-22",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Baker
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• Iqbal Singh Bal, M.D.
• Anwer Baloch, M.D.
• Travis Banks, CADC L
• Tiffani Angelica Barham, MD
• Alexandra Jasmine Thompson Barnes, FNP-C
• David R Baro, PA-C
• Ribhi Munif Barta, MD
• Gloria Godswill Basil, MD

• Forensic Psychologist in Porterville, CA
• Providers in Porterville, CA by specialty
• Forensic Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; 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.