Fiordaliza Pena-Sandoval

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2018037728 Issued in MO

Practice address

12401 E 43Rd St S Ste 121
Independence, MO 64055-5925

Phone

(816) 908-1469

NPI assigned

May 13, 2014

Last updated

Dec 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1942611983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 E PARTRIDGE AVE",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640551452",
            "telephone_number": "816-908-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 E 43RD ST S STE 121",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640555925",
            "telephone_number": "816-908-1469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA-SANDOVAL",
        "first_name": "FIORDALIZA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-13",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "4900",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2018037728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marci Cathleen Payne, LPC
• PBR Consulting LLC
• Susan Lynn Peach, LCSW
• Gwen C Pead, NP
• Julie Pearson
• Ashley Miledys Pena
• Jennifer M. Penix, PHARMD
• Jackie Marie Penland, LCSW
• Amanda Penn, PHARMD
• Lana Cay Pennell, D.O.

• Clinical Social Worker in Independence, MO
• Providers in Independence, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.