Provider Demographics
NPI:1053112912
Name:SANDOVAL, FATIMA
Entity type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:SANDOVAL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7957 PAINTER AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-2434
Mailing Address - Country:US
Mailing Address - Phone:562-572-9882
Mailing Address - Fax:562-572-9882
Practice Address - Street 1:7957 PAINTER AVE STE 203
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-2434
Practice Address - Country:US
Practice Address - Phone:562-572-9882
Practice Address - Fax:562-572-9882
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist