Individual provider Active NPI

Delsy Maria Sandoval, MFT INTERN

  • Rehabilitation Practitioner
  • San Fernando, CA
National Provider Identifier
1629474051
Registry record updated Jan 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
11565 Laurel Canyon Blvd Ste 116
San Fernando, CA 91340-4650
Phone
(818) 361-5030
Fax
(848) 361-1764
NPI assigned
Nov 12, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Primary

Addresses

Primary practice location

11565 Laurel Canyon Blvd Ste 116
San Fernando, CA 91340-4650

Mailing address

18541 Dearborn St Apt 10
Northridge, CA 91324-3045
Phone (818) 983-1716

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

NPI Registry JSON

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

{
    "created_epoch": "1415750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420502400000",
    "number": "1629474051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18541 DEARBORN ST APT 10",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913243045",
            "telephone_number": "818-983-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11565 LAUREL CANYON BLVD STE 116",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913404650",
            "telephone_number": "818-361-5030",
            "fax_number": "848-361-1764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "DELSY",
        "middle_name": "MARIA",
        "credential": "MFT INTERN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-12",
        "last_updated": "2015-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Fernando, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; 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.