NPIMap

Organization Active NPI

Mind Care Services

  • Psychiatry Physician
  • Long Beach, CA
National Provider Identifier
1922516962
Registry record updated Jan 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
324841 Issued in CA
Legal business name
MIND CARE SERVICES
Practice address
333 W Broadway Ste 310
Long Beach, CA 90802-4438
Phone
(949) 722-7118
NPI assigned
Jan 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2018

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

Authorized official

Name
Mrs. Sabrina Sandoval, MDNPI 1538370721
Title
Ceo
Phone
(317) 417-0656

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0800X 324841 CA Primary

Addresses

Primary practice location

333 W Broadway Ste 310
Long Beach, CA 90802-4438

Mailing address

2110 Ruhland Ave
Redondo Beach, CA 90278-2420
Phone (317) 417-0656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180131002908 CA Part B Supplier - Clinic/Group Practice 0345500831 Receives reassigned benefits from 1 practitioner
Practice locations: Long Beach, CA

National Provider Directory

National Provider Directory

Locations

333 W Broadway
Ste 310
Long Beach, CA 90802
Phone (562) 491-6465

7246 Rosemead Blvd
Pico Rivera, CA 90660
Phone (562) 949-2591

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515628800000",
    "number": "1922516962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 RUHLAND AVE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902782420",
            "telephone_number": "317-417-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W BROADWAY STE 310",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024438",
            "telephone_number": "949-722-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-11",
        "last_updated": "2018-01-11",
        "status": "A",
        "authorized_official_last_name": "SANDOVAL",
        "authorized_official_first_name": "SABRINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-417-0656",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "324841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.