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Individual
MS. MARY MADRIGAL SANDOVAL
Active
Individual
MS. MARY MADRIGAL SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, PHN, FNP
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
531242
CA
363LF0000X
Family Nurse Practitioner
Primary
95013490
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
531242
BOARD OF REGISTERED NURSING
CA
01
—
59378
BOARD OF REGISTERED NURSING
CA
01
—
95013490
BOARD OF REGISTERED NURSING
CA
Enumeration date
06/03/2013
Last updated
08/29/2020
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