Provider Demographics
NPI:1669268793
Name:SANDOVAL, VICTORIA JUDY (MA, AMFT, APCC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:JUDY
Last Name:SANDOVAL
Suffix:
Gender:F
Credentials:MA, AMFT, APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91788-0158
Mailing Address - Country:US
Mailing Address - Phone:909-996-7000
Mailing Address - Fax:
Practice Address - Street 1:21715 BUCKSKIN DR
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-0919
Practice Address - Country:US
Practice Address - Phone:909-996-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC18464101YP2500X
CAAMFT152411106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional