| Doctor Name: | MR. JOSE ANDRES SANDOVAL |
| NPI Number: | 1306181490 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 145 Faunce Corner Rd Ste K North Dartmouth, MA - 027471263 |
| Business Phone Number: | 7742061125 |
| Business Fax Number: | |
| Mailing Address: | 1610 Worcester Rd, A627 FRAMINGHAM |
| State: | MA |
| Postal Code: | 017025449 |
| Phone Number: | 9787323595 |
| Fax Number: | |
| NPI Enumeration Date: | 11/30/2012 |
| NPI Last Update Date: | 11/30/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |