Provider Demographics
NPI:1578807988
Name:SANDOVAL, FRANCINE (LCSW)
Entity type:Individual
Prefix:MS
First Name:FRANCINE
Middle Name:
Last Name:SANDOVAL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:FRANCINE
Other - Middle Name:
Other - Last Name:SAUCEDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2501 HUNTER PL STE 202
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-3940
Mailing Address - Country:US
Mailing Address - Phone:571-365-3172
Mailing Address - Fax:
Practice Address - Street 1:2501 HUNTER PL STE 202
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-3940
Practice Address - Country:US
Practice Address - Phone:571-365-3172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
CA559281041C0700X
VA09040103481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker