Jeannette Sandoval

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

95012896 Issued in CA

Practice address

22101 Redwood Rd Unit B
Unit B
Castro Valley, CA 94546-7107

Phone

(510) 648-9012

NPI assigned

Jan 6, 2020

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Escalon Physical Medicine IncGroup PAC ID 4880918192, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Escalon Physical Medicine, Inc

  dba Modesto Physical Medicine

  • Family Medicine Physician
  • Modesto, CA
  • NPI 1821417866
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578700800000",
    "number": "1376182402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 TWIN OAKS DR",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953778746",
            "telephone_number": "510-648-9012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22101 REDWOOD RD UNIT B",
            "address_2": "UNIT B",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945467107",
            "telephone_number": "510-648-9012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "JEANNETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-06",
        "last_updated": "2020-01-11",
        "certification_date": "2020-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "839846",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "95012896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lauren Sanchez
• Lindsay Marie Sanchez, ASW
• Patricia Gomez Sanchez
• Rachael Marion Sanders, LCSW
• Stephanie Headspeth Sanders, LCSW
• Samuel J Santoro, DO
• Eugene Thomas Santucci, DDS,
• Anna Maria Vito Sapugay, MD
• Sarita Satpathy, MD
• Linda Collette Schepis

• Family Medicine Physician in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2020; 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.