Individual
EVAN SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12062 W EDINGER AVE SPC 57, SANTA ANA, CA 92704-3820
(714) 251-9306
Mailing address
12062 W EDINGER AVE SPC 57, SANTA ANA, CA 92704-3820
(714) 251-9306
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
847359
CA
Other
Enumeration date
08/10/2014
Last updated
08/10/2014
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