Healthcare Provider Details

I. General information

NPI: 1033050331
Provider Name (Legal Business Name): DEANNA LAURA ESPINOSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 SAN PEDRO DR SE
ALBUQUERQUE NM
87108-5153
US

IV. Provider business mailing address

10235 VENTANA HILLS RD NW
ALBUQUERQUE NM
87114-4782
US

V. Phone/Fax

Practice location:
  • Phone: 505-265-1711
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number118653
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: