Stephanie Michelle Sandoval

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

107068 Issued in CA

Practice address

2425 Bisso LN Ste 200
Concord, CA 94520-4886

Phone

(925) 646-5468

NPI assigned

Jun 3, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730505600000",
    "number": "1821447541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 BISSO LN STE 200",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945204886",
            "telephone_number": "925-646-5468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 BISSO LN STE 200",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945204886",
            "telephone_number": "925-646-5468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "STEPHANIE",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-03",
        "last_updated": "2024-11-02",
        "certification_date": "2024-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "107068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Elizabeth Sandoval, BEHAVIOR ANALYST
• Ivana Jodell Sandoval
• Julia Sandoval
• Megan Julianna Sandoval
• Raymond Robert Sandoval III
• Teresa Sandoval
• Denise Sandri
• Derek T Sands
• Emily Sanfilippo
• Chartanique Alyce Sanford

• Clinical Social Worker in Concord, CA
• Providers in Concord, 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 Nov 2, 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.