Kenneth H Sandoval Jr., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

28243 Issued in CA

Practice address

5198 Arlington Ave # 922
Riverside, CA 92504-2603

Phone

(951) 538-1338

NPI assigned

May 30, 2013

Last updated

May 30, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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)

Enrolled

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

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369872000000",
    "number": "1477990505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5198 ARLINGTON AVE # 922",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925042603",
            "telephone_number": "951-538-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5198 ARLINGTON AVE # 922",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925042603",
            "telephone_number": "951-538-1338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "KENNETH",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-30",
        "last_updated": "2013-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "28243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irma Lorena Sandoval
• Jailene Sandoval, B.A
• Jessica Sandoval
• Jesus Sandoval
• Jorge Sandoval, MA, IMF
• Khalil Sandoval, NP
• Kristin Shareeka Sandoval, NP
• Nathalie Sandoval
• Nidia Sandoval
• Ruben Sandoval

• Clinical Social Worker in Riverside, CA
• Providers in Riverside, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; 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.