Jacquelyn Paola Sandoval, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C11220 Issued in OR

Practice address

1545 Harbeck Rd
Grants Pass, OR 97527-5605

Phone

(541) 476-2373

NPI assigned

Apr 22, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jacquelyn Paola Rodriguez Former name

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Texas Tech University Health Science Center School of Medicine, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Options for Southern Oregon

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grants Pass, OR
  • NPI 1558366492
  Medicare reassignment
• Options for Southern Oregon

  • Primary Care Clinic/Center
  • Grants Pass, OR
  • NPI 1952708422
  NPD

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

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770336000000",
    "number": "1265176523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 SW G ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262544",
            "telephone_number": "541-476-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 HARBECK RD",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275605",
            "telephone_number": "541-476-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "JACQUELYN",
        "middle_name": "PAOLA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-22",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C11220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "RODRIGUEZ",
            "middle_name": "PAOLA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David E Sanchez Vasquez, MD
• Hugo Sanchez II
• Rayna Sanchez
• Victoria Sanchez, LMT
• David Alan Sanders
• Shelby Ann Sanford, MSN
• Jennifer Santarelli, CADC
• Jonathan Santarelli, MS
• Raven Sara, LAC
• Jasmine Sarmiento

• Professional Counselor in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.