Provider Demographics
NPI:1619867975
Name:SANDOVAL, CHELSEA BROOKE (BSN, RN, CCRN, NAR)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:BROOKE
Last Name:SANDOVAL
Suffix:
Gender:F
Credentials:BSN, RN, CCRN, NAR
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:BROOKE
Other - Last Name:WIEDENFELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN, CCRN
Mailing Address - Street 1:3235 N ROVA CT
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-8244
Mailing Address - Country:US
Mailing Address - Phone:210-620-4868
Mailing Address - Fax:
Practice Address - Street 1:20 E RIVER PARK PL W
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-1551
Practice Address - Country:US
Practice Address - Phone:559-256-4950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX959095163W00000X
CA95306327163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse