| Mr Sergio Bautista Sandoval, LMFT | |
|
1400 Veterans Blvd, Redwood City, CA 94063-2612 | |
| (650) 299-6008 | |
| Not Available |
| Full Name | Mr Sergio Bautista Sandoval |
|---|---|
| Gender | Male |
| Speciality | Marriage & Family Therapist |
| Location | 1400 Veterans Blvd, Redwood City, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841608726 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 111726 (California) | Primary |
| Entity Name | Southern California Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
| Entity Name | Southern California Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Sergio Bautista Sandoval, LMFT 60 Rivas Ave, San Francisco, CA 94132-2139 Ph: (714) 323-8079 | Mr Sergio Bautista Sandoval, LMFT 1400 Veterans Blvd, Redwood City, CA 94063-2612 Ph: (650) 299-6008 |
Ziomara Ochoa, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 802 Brewster Ave, Redwood City, CA 94063 Phone: 650-363-4111 | |
Dr. Richard Mark Rusovick, LMFT, PHD Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 303 Twin Dolphin Dr, 6th Floor #74, Redwood City, CA 94065 Phone: 951-202-6799 | |
Alejandra Andrade, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 1400 Veterans Blvd, Redwood City, CA 94063 Phone: 650-299-4755 | |
Ms. Carol Sax Kahm, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 3789 Hoover St, Redwood City, CA 94063 Phone: 650-363-8769 | |
Mrs. Penny Thomas-proctor, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 165 Arch St, Redwood City, CA 94062 Phone: 650-363-0249 | |
Christopher Matthew Cincotta, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 2925 Carolina Ave, Redwood City, CA 94061 Phone: 123-456-7891 | |
Sheryl Corchnoy, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 400 Edmonds Rd, Redwood City, CA 94062 Phone: 650-312-5262 |