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NPI Code Detail

MEDICARE: MS. CINDY BEATRIZ SANDOVAL BCBA

MEDICARE: MS. CINDY BEATRIZ SANDOVAL BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-11-8000CA

General Provider Information

NPI Number : 1306103908
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CINDY BEATRIZ SANDOVAL BCBA
Provider Business Mailing Address
First Line : 624 COMMERCE AVE STE E
Second Line :
City : PALMDALE
State : CA
Zip : 93551-3883
Country : US
Telephone Number : 661-215-2749
Fax Number :
Provider Business Practice Location Address
First Line : 16946 SHERMAN WAY STE 200
Second Line :
City : VAN NUYS
State : CA
Zip : 91406-3613
Country : US
Telephone Number : 818-235-1414
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2012
Last Update Date : 04/19/2012

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