Tina Lynne Sandoval, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

60777147 Issued in WA

Practice address

1217 Cooper Point Rd SW
Olympia, WA 98502-7204

Phone

(360) 464-9052

NPI assigned

Aug 3, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• L.E.a.P.S and Beyond, Inc

  • Community/Behavioral Health Agency
  • Oak Harbor, WA
  • NPI 1538504592
  NPD (past)
• L.E.a.P.S. and Beyond, Inc

  • Behavior Analyst
  • Port Orchard, WA
  • NPI 1083089981
  NPD (past)

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1316462039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6513 197TH CT SW",
            "city": "ROCHESTER",
            "state": "WA",
            "postal_code": "985798692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 COOPER POINT RD SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985027204",
            "telephone_number": "360-464-9052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "TINA",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-03",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "60777147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter J Sanderson, LMFT, MHP, CMHS
• Jagjit Singh Sandhu
• Sandifer Chiropractic Clinic, Inc. P.S.
• Grace Sandifer, LMT
• Leamon C. Sandifer, DC
• Gary R Sandwick, MA
• Guntas Kaur Sangha, MD
• Luis F Santamarina, M.D.
• Bernadine Santi, RPH
• Enrique Ferdinand Santiago

• Behavior Analyst in Olympia, WA
• Providers in Olympia, WA by specialty
• Behavior Analyst in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.

Verify at the official NPI Registry.