Provider Demographics
NPI:1073363339
Name:SANDOVAL, JEANNE MARIE (APCC)
Entity Type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:MARIE
Last Name:SANDOVAL
Suffix:
Gender:F
Credentials:APCC
Other - Prefix:MISS
Other - First Name:JEANNE
Other - Middle Name:MARIE
Other - Last Name:ZELASKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27201 TOURNEY RD STE 200D
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1855
Mailing Address - Country:US
Mailing Address - Phone:747-900-2204
Mailing Address - Fax:
Practice Address - Street 1:27201 TOURNEY RD STE 200D
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1855
Practice Address - Country:US
Practice Address - Phone:747-900-2204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC15802101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health