Individual
REBECCA MAE SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
57818 WEATHERED PINE CT, ELKHART, IN 46517-8811
(574) 343-3515
Mailing address
57818 WEATHERED PINE CT, ELKHART, IN 46517-8811
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
IN
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/09/2023
Last updated
04/15/2026
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