Individual provider Active NPI

Hector Manuel Sandoval

  • Clinical Social Worker
  • Lynwood, CA
National Provider Identifier
1922515501
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
111183 Issued in CA
Practice address
2640 Industry Way
Lynwood, CA 90262-4284
Phone
(310) 627-4525
NPI assigned
Jan 4, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 111183 CA
Case Manager/Care Coordinator 171M00000X
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 111183 CA Primary

Addresses

Primary practice location

2640 Industry Way
Lynwood, CA 90262-4284

Mailing address

2640 Industry Way
Lynwood, CA 90262-4284
Phone (310) 627-4525

Other practice location 1

3850 Crenshaw Blvd
Los Angeles, CA 90008-1821
Phone (323) 751-3026

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

LicenseStateTypeSpecialty
111183CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Health & Rehabilitation Program PastSince Jun 1, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1922515501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 INDUSTRY WAY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624284",
            "telephone_number": "310-627-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 INDUSTRY WAY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624284",
            "telephone_number": "310-627-4525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3850 Crenshaw Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900081821",
            "country_code": "US",
            "telephone_number": "323-751-3026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "HECTOR",
        "middle_name": "MANUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-04",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "111183",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "111183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.