Individual provider Active NPI

Melissa Sandoval

  • Social Worker
  • Chino, CA
National Provider Identifier
1457013849
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
129717 Issued in CA
Practice address
12909 Boston Ave
Chino, CA 91710-5934
Phone
(310) 629-4280
NPI assigned
Oct 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 129717 CA
Social Worker 104100000X 129717 CA Primary

Addresses

Primary practice location

12909 Boston Ave
Chino, CA 91710-5934

Mailing address

1511 Willow Dr
Norco, CA 92860-2771
Phone (310) 629-4280

Other practice location 1

1511 Willow Dr
Norco, CA 92860-2771
Phone (310) 629-4280

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

LicenseStateTypeSpecialty
129717CAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1457013849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 WILLOW DR",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928602771",
            "telephone_number": "310-629-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12909 BOSTON AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917105934",
            "telephone_number": "310-629-4280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1511 Willow Dr",
            "address_purpose": "LOCATION",
            "city": "Norco",
            "state": "CA",
            "postal_code": "928602771",
            "country_code": "US",
            "telephone_number": "310-629-4280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "MELISSA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "129717",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "129717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; 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.