Provider Demographics
NPI:1285867085
Name:SANDOVAL, YVONNE (HIS)
Entity Type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:
Last Name:SANDOVAL
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2143 W FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92545-3601
Mailing Address - Country:US
Mailing Address - Phone:951-925-8100
Mailing Address - Fax:951-925-7300
Practice Address - Street 1:2143 W FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92545-3601
Practice Address - Country:US
Practice Address - Phone:951-925-8100
Practice Address - Fax:951-925-7300
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2011-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA7526237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist