Active NPI
Preston Sandoval, COUNSELOR
- Addiction (Substance Use Disorder) Counselor
- Ojo Encino, NM
National Provider Identifier
1811269608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 0089811
- Practice address
- HC 79 Box 1510
Ojo Encino, NM 87013-9612 - Phone
- (505) 731-1505
- Fax
- (505) 731-1502
- NPI assigned
- Feb 8, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 0089811 | NM | Primary |
Addresses
Primary practice location
HC 79 Box 1510
Ojo Encino, NM 87013-9612
Mailing address
HC 79 Box 1510
Ojo Encino, NM 87013-9612
Phone (505) 731-1505
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0089811 | NM | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328659200000",
"number": "1811269608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 79 BOX 1510",
"city": "OJO ENCINO",
"state": "NM",
"postal_code": "870139612",
"telephone_number": "505-731-1505",
"fax_number": "505-731-1502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HC 79 BOX 1510",
"city": "OJO ENCINO",
"state": "NM",
"postal_code": "870139612",
"telephone_number": "505-731-1505",
"fax_number": "505-731-1502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDOVAL",
"first_name": "PRESTON",
"name_prefix": "Mr.",
"credential": "COUNSELOR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-08",
"last_updated": "2012-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NM",
"license": "0089811",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ojo Encino, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.