Active NPI
Keren Sandoval
- Social Worker
- Upland, CA
National Provider Identifier
1316445836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 113723
- Practice address
- 870 N Mountain Ave Ste 206
Upland, CA 91786-4173 - Phone
- (800) 906-0862
- NPI assigned
- Jan 30, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 113723 | CA | Primary |
Addresses
Primary practice location
870 N Mountain Ave Ste 206
Upland, CA 91786-4173
Mailing address
870 N Mountain Ave Ste 206
Upland, CA 91786-4173
Phone (800) 906-0862
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 113723 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728259200000",
"number": "1316445836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "870 N MOUNTAIN AVE STE 206",
"city": "UPLAND",
"state": "CA",
"postal_code": "917864173",
"telephone_number": "800-906-0862"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "870 N MOUNTAIN AVE STE 206",
"city": "UPLAND",
"state": "CA",
"postal_code": "917864173",
"telephone_number": "800-906-0862"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDOVAL",
"first_name": "KEREN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-30",
"last_updated": "2024-10-07",
"certification_date": "2024-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "113723",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Upland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.