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General NPI Number Information
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NPI Number | 1467307017
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Entity Type | Organization
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Legal Business Name | BONSAI COUNSELING & PSYCHOTHERAPY, A LICENSED CLINICAL SOCIAL WORKER PC
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Dates
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Enumeration Date | 02/27/2026
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 7471 RED WILLOW ST
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City | SACRAMENTO
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State | CA
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Zip | 95822-5127
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Country | US
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Telephone | 916-520-3041
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Fax |
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Provider Business Mailing Address
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Address Line | 8300 DELTA SHORES CIR S #235 STE 120
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City | SACRAMENTO
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State | CA
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Zip | 95832-9114
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAMIAN SAUL SANDOVAL
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Credential | LCSW
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Telephone | 805-701-3009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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