SAN JUAN HEALTH AND WELLNESS CENTER NPI 1568998029

NPI Information

NPI: 1568998029
Provider Name: SAN JUAN HEALTH AND WELLNESS CENTER
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
4801 N BUTLER AVE
STE 1101
FARMINGTON, NM
ZIP 87401
Phone: (505) 327-0002
Get Directions

SAN JUAN HEALTH AND WELLNESS CENTER is a psychiatric/mental health nurse practitioner in Farmington, NM. SAN JUAN HEALTH AND WELLNESS CENTER NPI is 1568998029. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4801 N BUTLER AVE
STE 1101
FARMINGTON, NM
ZIP 87401-013
Phone: (505) 327-0002
Fax: (505) 325-9443

The provider's authorized official is Misty Dawn Diaz .
The authorized official title is Office Administrator and has the following contact phone number (505) 327-0002.

The enumeration date for this NPI number is 5/3/2017 and was last updated on 12/29/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	1041C0700X	Social Worker	Clinical	No
2	2084P0800X	Psychiatry & Neurology	Psychiatry	No
3	363LF0000X	Nurse Practitioner	Family	No
4	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	86337556	MEDICAID	NEW MEXICO
2	2782	OTHER	NEW MEXICO	LAST FOUR OF TIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »