Marissa Sandoval, SUD RC #15775

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

161 N Date St
Escondido, CA 92025-3405

Phone

(760) 745-7786

Fax

(760) 745-1061

NPI assigned

Jul 12, 2023

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1841979481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20135 ROSS RD",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925958273",
            "telephone_number": "951-385-3522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 N DATE ST",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253405",
            "telephone_number": "760-745-7786",
            "fax_number": "760-745-1061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "MARISSA",
        "name_prefix": "Ms.",
        "credential": "SUD RC #15775",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gwana Sanders, M.S., M.A., RAD-I
• Heather Sanders
• Debra Marie Sandgren, LMFT
• Narmi Sandoval Playa
• Ame Eriberta Sandoval
• Ryan Christopher Sandoval, RADT-I
• Hannah Sandy, PT, DPT
• Michaela Sandy
• Shirley Sankey, HEALTH COACH
• Carmen Santa Cruz

• Addiction (Substance Use Disorder) Counselor in Escondido, CA
• Providers in Escondido, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.