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General NPI Number Information
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NPI Number | 1366109266
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Entity Type | Individual
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Provider Name | DALILA SANDOVAL ASW
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Gender | Female
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Dates
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Enumeration Date | 11/26/2021
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Last Update Date | 11/26/2021
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Provider Practice Location Address
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Address Line | 5425 SIERRA VISTA AVE
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City | RIVERSIDE
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State | CA
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Zip | 92505-3113
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Country | US
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Telephone | 951-299-7645
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Fax |
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Provider Business Mailing Address
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Address Line | 420 N MCKINLEY ST # 111-161
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City | CORONA
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State | CA
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Zip | 92879-8099
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Country | US
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Telephone | 951-529-7706
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 100429
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License Number State | CA
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