Healthcare Provider Details

I. General information

NPI: 1871746925
Provider Name (Legal Business Name): CHRISTOPHER ADAM NEUMANN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2008
Last Update Date: 01/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 UNIVERSITY BLVD NE FAMILY HEALTH CLINIC
ALBUQUERQUE NM
87102-1727
US

IV. Provider business mailing address

8624 GREENARBOR RD NE
ALBUQUERQUE NM
87122-2612
US

V. Phone/Fax

Practice location:
  • Phone: 305-793-7459
  • Fax:
Mailing address:
  • Phone: 505-272-1548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2008015697
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1253
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: