Healthcare Provider Details
I. General information
NPI: 1063293256
Provider Name (Legal Business Name): A NEW FOCUS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/12/2023
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6801 JEFFERSON ST NE STE 150
ALBUQUERQUE NM
87109-4379
US
IV. Provider business mailing address
6801 JEFFERSON ST NE STE 150
ALBUQUERQUE NM
87109-4379
US
V. Phone/Fax
- Phone: 505-974-0917
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROSANNA
CORDOVA
Title or Position: OWNER
Credential:
Phone: 505-974-0917