Healthcare Provider Details

I. General information

NPI: 1316036379
Provider Name (Legal Business Name): JAMES T HOBSON LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 CARDENAS DR NE
ALBUQUERQUE NM
87108-1709
US

IV. Provider business mailing address

209 CARDENAS DR NE
ALBUQUERQUE NM
87108-1709
US

V. Phone/Fax

Practice location:
  • Phone: 505-254-9428
  • Fax: 505-254-8769
Mailing address:
  • Phone: 505-254-9428
  • Fax: 505-254-8769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberM-05696
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: