Healthcare Provider Details

I. General information

NPI: 1679551659
Provider Name (Legal Business Name): JORGE GABRIEL VARELA PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL SCIENCES UNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE
ALBUQUERQUE NM
87131-0001
US

IV. Provider business mailing address

800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-2223
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY-2025-0080
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: