Healthcare Provider Details
I. General information
NPI: 1972471217
Provider Name (Legal Business Name): ERIKA VILLANUEVA
Entity Type: Individual
Gender:
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/28/2025
Last Update Date: 10/28/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2155 LOUISIANA BLVD NE STE 4200
ALBUQUERQUE NM
87110-5433
US
IV. Provider business mailing address
2155 LOUISIANA BLVD NE STE 4200
ALBUQUERQUE NM
87110-5433
US
V. Phone/Fax
- Phone: 505-266-0441
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: