Jacqueline Sandoval, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2140328 Issued in TX

Practice address

9650 Kenworthy St
El Paso, TX 79924-6011

Phone

(915) 751-0967

NPI assigned

Aug 27, 2024

Sex

Female

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1724716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1801620455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 FE JACKSON RD",
            "city": "SOCORRO",
            "state": "TX",
            "postal_code": "799271291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9650 KENWORTHY ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799246011",
            "telephone_number": "915-751-0967"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1605 Chelsea St",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799032203",
            "country_code": "US",
            "telephone_number": "915-540-1585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "JACQUELINE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-27",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2140328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sanjeet S Sandhu, D.O.
• Kaisa Elizabeth Sandoval Rangel
• Christina Sandoval
• Eric Sandoval, MD
• Ivan Sandoval
• Jessica Rae Sandoval, BCBA, LBA, ACAS
• Manuel Alfonso Sandoval, MD
• Wendy Lynn Sandoval, AGPCNP-BC
• Stephen Eugene Sandroni, MD
• Victoria Sank, PSY.D.

• Physical Therapy Assistant in El Paso, TX
• Providers in El Paso, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.