Provider Demographics
NPI:1235021049
Name:CERVANTEZ-SANDOVAL, SETH AYDEN
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:AYDEN
Last Name:CERVANTEZ-SANDOVAL
Suffix:
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 1:901 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-1406
Mailing Address - Country:US
Mailing Address - Phone:805-963-1086
Mailing Address - Fax:805-963-1086
Practice Address - Street 1:901 OLIVE ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-1406
Practice Address - Country:US
Practice Address - Phone:805-963-1086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No172V00000XOther Service ProvidersCommunity Health Worker