Provider Demographics
NPI:1467639310
Name:GARCIA SANDOVAL, MARIA D
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:D
Last Name:GARCIA SANDOVAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1471 B ST STE N
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:CA
Mailing Address - Zip Code:95334-1426
Mailing Address - Country:US
Mailing Address - Phone:209-394-4032
Mailing Address - Fax:209-394-4166
Practice Address - Street 1:1471 B ST STE N
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:CA
Practice Address - Zip Code:95334-1426
Practice Address - Country:US
Practice Address - Phone:209-394-4032
Practice Address - Fax:209-394-4166
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-23
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW85689101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health