Active NPI
Theary Eng Sandoval
- Clinical Social Worker
- Corcoran, CA
National Provider Identifier
1992473466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 85609
- Practice address
- 900 Quebec Ave
Corcoran, CA 93212-9715 - Phone
- (559) 992-7100
- NPI assigned
- Aug 31, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 85609 | CA | Primary |
Addresses
Primary practice location
900 Quebec Ave
Corcoran, CA 93212-9715
Mailing address
605 Centennial Dr Apt B
Hanford, CA 93230-7476
Phone (559) 992-7100
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
| License | State | Type | Specialty |
|---|---|---|---|
| 85609 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674518400000",
"number": "1992473466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "605 CENTENNIAL DR APT B",
"city": "HANFORD",
"state": "CA",
"postal_code": "932307476",
"telephone_number": "559-992-7100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 QUEBEC AVE",
"city": "CORCORAN",
"state": "CA",
"postal_code": "932129715",
"telephone_number": "559-992-7100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDOVAL",
"first_name": "THEARY",
"middle_name": "ENG",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-31",
"last_updated": "2023-01-24",
"certification_date": "2023-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "85609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corcoran, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.