Active NPI
Bianca Sandoval
- Speech-Language Assistant
- Phoenix, AZ
National Provider Identifier
1346744968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 11109
- Practice address
- 11201 N Tatum Blvd
Phoenix, AZ 85028-6036 - Phone
- (602) 689-0495
- NPI assigned
- Mar 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | 11109 | AZ | Primary |
Addresses
Primary practice location
11201 N Tatum Blvd
Phoenix, AZ 85028-6036
Mailing address
6822 N 31St Dr
Phoenix, AZ 85017-1112
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 |
|---|---|---|---|
| 11109 | AZ | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521504000000",
"number": "1346744968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6822 N 31ST DR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850171112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11201 N TATUM BLVD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850286036",
"telephone_number": "602-689-0495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDOVAL",
"first_name": "BIANCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-20",
"last_updated": "2018-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "AZ",
"license": "11109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.