JEANNETTE SANDOVAL – Family Medicine Physician, NPI 1376182402

JEANNETTE SANDOVAL is a healthcare provider. based in Tracy, California. specializing in NURSE PRACTITIONER. They hold a License No. 839846 (CA). The NPI Number for JEANNETTE SANDOVAL is 1376182402

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
JEANNETTE SANDOVAL
NPI
1376182402
Phone
(510) 648-9012
Address
744 TWIN OAKS DR
Enumeration Date
6 January 2020
Last Update Date
11 January 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2098383434
Graduation Year
2019 (7 years ago)
PAC ID
5890131288
Group Practice PAC ID
4880918192
Professional Enrollment ID
I20240307002245
Address ID
CA953552704MO1933XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:6State licenses:2Digital endpointsOther names

16,360 NURSE PRACTITIONER in CA

Provider Addresses for JEANNETTE SANDOVAL

  • 744 TWIN OAKS DR

    TRACY, CA 953778746

    Phone: (510) 648-9012

    Type: Mailing

  • 22101 REDWOOD RD UNIT B

    UNIT B

    CASTRO VALLEY, CA 945467107

    Phone: (510) 648-9012

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-03-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240307002245INurse PractitionerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95377)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4880918192View full group profile
NameSpecialtyState
C H I R O P R A C T I CUT
C H I R O P R A C T I CCA

Reviews

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Frequently asked questions

How do payers reference JEANNETTE SANDOVAL?
For JEANNETTE SANDOVAL, use NPI 1376182402 as the unique 10-digit identifier.
Is there an active status for JEANNETTE SANDOVAL?
For scheduling context, JEANNETTE SANDOVAL is shown as active in the registry.
What kind of doctor is JEANNETTE SANDOVAL?
JEANNETTE SANDOVAL is associated with Family Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for JEANNETTE SANDOVAL?
Travel planning: use Tracy, California as the reference point for JEANNETTE SANDOVAL, then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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