Sandra Nicole Prime

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

430 F St
Chula Vista, CA 91910-3711

Phone

(619) 420-3620

NPI assigned

Jan 13, 2022

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

Other identifiers 1

Electronic endpoints 1

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": "1642032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1912658782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 F ST APT C4",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919103739",
            "telephone_number": "626-268-7897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 F ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919103711",
            "telephone_number": "619-420-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIME",
        "first_name": "SANDRA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-13",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "911-87726-04",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://secure.etosoftware.com/Login.aspx",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "430 F St",
            "city": "Chula Vista",
            "state": "CA",
            "country_code": "US",
            "postal_code": "919103711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emilio S. Prieto
• Jacqueline Prieto
• Prime Healthcare Paradise Valley LLC (Paradise Valley Hospital)
• Prime Healthcare Paradise Valley LLC (Bayview CSU)
• Prime Healthcare, Inc (Prime Ally Program)
• Deneitris Pringle
• Sandra A Printup
• Prisma Care, a Medical Corporation
• Carli Irene Proctor, LMFT
• Linda Proctor, LCSW

• Counselor in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; 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.