Healthcare Provider Details

I. General information

NPI: 1588305825
Provider Name (Legal Business Name): VIRIDIANA SAENZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2022
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19200 JAMBOREE RD STE 3100
IRVINE CA
92612-2571
US

IV. Provider business mailing address

805 MORNINGSIDE PL SE
ALBUQUERQUE NM
87108-3358
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-7002
  • Fax:
Mailing address:
  • Phone: 915-248-7246
  • Fax: 505-272-8045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD2025-0258
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA210567
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberMD2025-0258
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: