Healthcare Provider Details

I. General information

NPI: 1508796996
Provider Name (Legal Business Name): ASHLEY SANDOVAL CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15600 CONCORD CIR
MORGAN HILL CA
95037-7110
US

IV. Provider business mailing address

1470 REVERE AVE
SAN JOSE CA
95118-1148
US

V. Phone/Fax

Practice location:
  • Phone: 408-201-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number40680
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: