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General NPI Number Information
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NPI Number | 1558787259
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Entity Type | Individual
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Provider Name | EILEEN MAXINE SANDOVAL LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/05/2014
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Last Update Date | 07/18/2022
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Provider Practice Location Address
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Address Line | 1011 G ST STE 5
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City | REEDLEY
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State | CA
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Zip | 93654-2935
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Country | US
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Telephone | 559-551-1400
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Fax | 559-551-1414
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Provider Business Mailing Address
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Address Line | PO BOX 211
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City | REEDLEY
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State | CA
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Zip | 93654-0211
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Country | US
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Telephone | 559-551-1400
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Fax | 559-551-1414
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 79187
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 115318
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License Number State | CA
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