Provider Demographics
NPI:1699090738
Name:SANDOVAL, EFREN JR
Entity type:Individual
Prefix:MR
First Name:EFREN
Middle Name:
Last Name:SANDOVAL
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 MISSION ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2631
Mailing Address - Country:US
Mailing Address - Phone:415-864-7833
Mailing Address - Fax:415-864-7093
Practice Address - Street 1:545 JONES ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-2007
Practice Address - Country:US
Practice Address - Phone:415-864-7833
Practice Address - Fax:415-864-7093
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 171M00000X
CA225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator