MR. MARIO ALBERTO SANDOVAL (NPI# 1750429932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750429932 |
| Entity Type | Individual |
| Full Name | MR. MARIO ALBERTO SANDOVAL |
| Practice Address |
1100 Grundy Ln San Bruno CA 94066-3065 |
| Mailing Address |
1 Embarcadero Ctr Ste 1900 San Francisco CA 94111-3723 |
| Practice Telephone | 8882011937 |
| Mailing Telephone | 4156586791 |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-06-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY26154 | CA | Behavioral Health & Social Service Providers |
| Street Address |
1100 GRUNDY LN |
| City | SAN BRUNO |
| State | CA |
| Zip Code | 94066-3065 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164509097 | Sue Kim | Internal Medicine | 1100 Grundy Ln, San Bruno, CA 94066-3065 | 2006-10-31 |
| 1376189837 | One Medical Group, Inc. | Internal Medicine | 1100 Grundy Ln, San Bruno, CA 94066-3065 | 2019-11-20 |
| 1487213781 | One Medical Group, Inc. | Internal Medicine | 1100 Grundy Ln, San Bruno, CA 94066-3065 | 2019-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497392468 | Harold Relosimon | Behavior Technician | 901 Sneath Lane, Suite 105, San Bruno, Ca 94066, San Bruno, CA 94066 | 2019-12-09 |
| 1093365926 | Liana Greene | Behavior Technician | 1001 Sneath Lane #200, San Bruno, CA 94066 | 2019-09-12 |
| 1568018406 | Susan Page Gadegone | Community Health Worker | 931 San Bruno West Avenue Suite 2, San Bruno, CA 94066 | 2019-08-15 |
| 1184198780 | Sonya Oey Kramer | Pharmacist | 10 Bayhill Drive, San Bruno, CA 94066 | 2019-01-16 |
| 1316410350 | Brennen Marques Mcdowell | Behavioral Analyst | 101 Sneath Lane Ste. 200, 200, San Bruno, CA 94066 | 2019-01-02 |
| 1306317649 | Jacqueline R Lalucis | Behavior Technician | 751 Camino Plaza, San Bruno, Ca 94066, A, San Bruno, CA 94066 | 2018-12-16 |
| 1992275952 | Kenny Malunay | Behavior Technician | 75a El Camino Plaza, San Bruno, CA 94066 | 2018-12-03 |
| 1396236584 | Mariela Pena Yerena | Behavior Technician | 751 El Camino Plaza, Suite A, San Bruno, CA 94066 | 2018-05-23 |
| 1568845816 | Paula Leeanne Park | Physical Therapist | 106 Quail Point Cir, San Bruno, CA 94066 | 2015-07-06 |
| 1275921231 | C & C's Care Home | Assisted Living Facility | 2700 Oakmont Dr., San Bruno, CA 94066 | 2014-12-29 |
| Find all providers in zip 94066 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578620464 | Ori Kochavi | Psychologist | 801 Traeger Ave Ste 209, Kaiser - Dept. of Child & Adolescent Psychiatry, San Bruno, CA 94066-3048 | 2007-01-02 |
| 1235235821 | Dr Oscar F Cervantes Clinical Psychologist Inc | Psychologist | 715 El Camino Real # 210, San Bruno, CA 94066 | 2006-09-15 |
| 1104298603 | Nathan Ewigman | Psychologist | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2015-10-22 |
| 1740521970 | Kelly Hwa Koo | Psychologist | 1001 Sneath Ln, Suite 300, San Bruno, CA 94066-2308 | 2013-03-13 |
| 1629224878 | Oscar F. Cervantes | Psychologist | 715 El Camino Real, #209, San Bruno, CA 94066-3426 | 2008-08-07 |
| 1831244458 | Bradley Alan Siu | Psychologist | 801 Traeger Ave, 209, San Bruno, CA 94066-3048 | 2007-01-24 |
| 1841341534 | Eric Scott Hooe | Psychologist | 1001 Sneath Ln, Suite 204, San Bruno, CA 94066-2308 | 2007-01-16 |
| 1023167665 | April C. Vogensen-cascao | Psychologist | 801 Traeger Ave, Kaiser Child Psychiatry, 2nd Floor, San Bruno, CA 94066-3048 | 2007-01-10 |
| 1619033248 | Kathleen Anne Mulherin | Psychologist | 1001 Sneath Ln, Suite 204, San Bruno, CA 94066-2308 | 2006-12-28 |
| 1508926783 | Kate Jane Riley | Psychologist | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2006-12-11 |
| Find all providers in SAN BRUNO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.