Active NPI
Josephine Jennifer Coffey Sandoval, O.D.
- Pediatric Optometrist
- Roseville, CA
National Provider Identifier
1316259609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Optometrist
- License
- OPT15177
- Practice address
- 1620 E Roseville Pkwy Ste 200
Roseville, CA 95661-3303 - Phone
- (916) 771-0251
- NPI assigned
- Jul 2, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Optometrist | 152WP0200X | 4875 | MA | |
| Pediatric Optometrist | 152WP0200X | OPT15177 | CA | Primary |
Addresses
Primary practice location
1620 E Roseville Pkwy Ste 200
Roseville, CA 95661-3303
Mailing address
5017 U St
Sacramento, CA 95817-1530
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT15177 | CA | MD | Pediatric Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital Corporation | Past | Accepting new patients | |
| Childrens Hospital of Los Angeles | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 2
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.
-
- Children's Hospital
- Los Angeles, CA
- NPI 1124073366
-
- Children's Hospital
- Boston, MA
- NPI 1710087127
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645574400000",
"number": "1316259609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5017 U ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958171530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 E ROSEVILLE PKWY STE 200",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956613303",
"telephone_number": "916-771-0251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COFFEY SANDOVAL",
"first_name": "JOSEPHINE",
"middle_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-02",
"last_updated": "2022-02-23",
"certification_date": "2022-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "MA",
"license": "4875",
"primary": false
},
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "CA",
"license": "OPT15177",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.