MEDICARE: DR. ALEJANDRO CERVANTES PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist	1739	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184014300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEJANDRO CERVANTES PHD

Provider Business Mailing Address
First Line	:	2801 MISSOURI AVE STE 36
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-9151
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2801 MISSOURI AVE STE 36
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-9151
Country	:	US
Telephone Number	:	626-252-9246
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2015
Last Update Date	:	05/06/2025

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