Provider Demographics
NPI:1871910216
Name:SANDOVAL, MARGARITA (RN)
Entity type:Individual
Prefix:MS
First Name:MARGARITA
Middle Name:
Last Name:SANDOVAL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10412 STOBAUGH ST
Mailing Address - Street 2:# 206
Mailing Address - City:LAMONT
Mailing Address - State:CA
Mailing Address - Zip Code:93241-1748
Mailing Address - Country:US
Mailing Address - Phone:661-845-6240
Mailing Address - Fax:
Practice Address - Street 1:10412 STOBAUGH ST
Practice Address - Street 2:# 206
Practice Address - City:LAMONT
Practice Address - State:CA
Practice Address - Zip Code:93241-1748
Practice Address - Country:US
Practice Address - Phone:661-845-6240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-24
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA663692163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care