Luz Adriana Donato-Sandoval
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Patton, CA
NPI 1972124691 · NPPES record last updated May 10, 2022
Key facts
- NPI
- 1972124691
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 3102 E Highland Ave
Patton, CA 92369-7813 - Phone
- (714) 299-4575
- NPI assigned
- May 4, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1215 O St
Ms 3
Sacramento, CA 95814-5685
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260605002128 | CA | Practitioner - Clinical Psychologist | 7012488455 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Telecare Corporation | Past |
Accepting new patients | |
| Telecare Corporation | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes | ||
| Mental Health Counselor | 101YM0800X | CA |
Addresses
Primary practice location
3102 E Highland Ave
Patton, CA 92369-7813
Mailing address
840 W la Jolla St Apt 1a
Placentia, CA 92870-7049
Phone (714) 299-4575
Other practice location 1
18646 Oxnard St
Tarzana, CA 91356-1411
Phone (818) 996-1051
Other practice location 2
2026 W Beacon Ave
Anaheim, CA 92804-4406
Phone (657) 276-7030
Other providers in Patton, CA
- Michael Dale Dewit
- Inderpal Dhillon
- Eddie Lee Diaz
- Nilda Diaz
- Grace D Dobey
- Jennifer Doswell
- Ramila D Duwal
- Aya Eguchi
- Michael Ehlers
- Joy Tuesday Ramas Engracia
All providers in Patton, CA · Student in an Organized Health Care Education/Training Program in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.