Individual provider Active NPI

Lea Anne Sandoval, RPH

  • Pharmacist
  • Huntington Beach, CA
National Provider Identifier
1740564848
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH 43939 Issued in CA
Practice address
17522 Beach Blvd
Huntington Beach, CA 92647-6802
Phone
(714) 596-5272
NPI assigned
Oct 6, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH 43939 CA Primary

Addresses

Primary practice location

17522 Beach Blvd
Huntington Beach, CA 92647-6802

Mailing address

16775 Bridgeport St
Fountain Valley, CA 92708-2902
Phone (714) 963-9816

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RPH 43939CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1317859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1740564848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16775 BRIDGEPORT ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082902",
            "telephone_number": "714-963-9816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17522 BEACH BLVD",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926476802",
            "telephone_number": "714-596-5272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "LEA",
        "middle_name": "ANNE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-06",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH 43939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; 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.