Individual provider Active NPI

Andrea Marie Sandoval, MS, LMFT

  • Marriage & Family Therapist
  • Blythe, CA
National Provider Identifier
1134419716
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
87916 Issued in CA
Practice address
1297 W Hobsonway
Blythe, CA 92225-1423
Phone
(760) 921-5000
NPI assigned
Apr 15, 2011
Last updated
Aug 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 202765 TX
Marriage & Family Therapist 106H00000X 87916 CA Primary

Addresses

Primary practice location

1297 W Hobsonway
Blythe, CA 92225-1423

Mailing address

2085 Rustin Ave.
Riverside, CA 92507
Phone (951) 955-7320

Other practice location 1

47825 Oasis St
Indio, CA 92201-6950
Phone (760) 863-8071

Other practice location 2

2085 Rustin Ave
Riverside, CA 92507-2498
Phone (951) 955-7320

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

LicenseStateTypeSpecialty
87916CAMDMarriage & Family Therapist
202765TXMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Andrea's Counseling, PLLC Marriage & Family Therapist Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1302825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1134419716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 RUSTIN AVE.",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92507",
            "telephone_number": "951-955-7320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1297 W HOBSONWAY",
            "city": "BLYTHE",
            "state": "CA",
            "postal_code": "922251423",
            "telephone_number": "760-921-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47825 Oasis St",
            "address_purpose": "LOCATION",
            "city": "Indio",
            "state": "CA",
            "postal_code": "922016950",
            "country_code": "US",
            "telephone_number": "760-863-8071",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2085 Rustin Ave",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925072498",
            "country_code": "US",
            "telephone_number": "951-955-7320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MS, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-15",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "202765",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "87916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blythe, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.