Jennifer M Sandoval, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY27635 Issued in CA

Practice address

26266 Meridian St
Hemet, CA 92544-6486

Phone

(657) 217-1141

Fax

(657) 202-1898

NPI assigned

Oct 2, 2015

Sex

Female

Sole proprietor

Yes

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.

• Soul in Mind Psychological Services Inc

  • Clinical Psychologist
  • Hemet, CA
  • NPI 1669231908

  Adult Development & Aging

  NPD Authorized official
• Soul in Mind Psychological Services, SBC

  • Clinical Psychologist
  • Hemet, CA
  • NPI 1528776945

  Adult Development & Aging

  NPD Authorized official

Specialty

Clinical Psychologist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 15, 2022.

{
    "created_epoch": "1443744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1912377953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26266 MERIDIAN ST",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925446486",
            "telephone_number": "657-217-1141",
            "fax_number": "657-217-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26266 MERIDIAN ST",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925446486",
            "telephone_number": "657-217-1141",
            "fax_number": "657-202-1898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-02",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "CA",
            "license": "PSY27635",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY27635",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruby Sanchez
• John Robert Sanders
• Laura Sanders
• Basant Singh Sandhu, M.D
• Alexandra Sandoval
• Yvonne Sandoval, HIS
• Mahmoud Hamidi Sani, M.D.
• Jogin Santiago
• Eseosa Jennifer Sanwo
• Marina Sarkis

• All providers in Hemet, CA
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.