Healthcare Provider Details

I. General information

NPI: 1205702313
Provider Name (Legal Business Name): YESENIA ALVARADO HUERIGO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 LOS ARBOLES AVE NW APT B
ALBUQUERQUE NM
87107-1288
US

IV. Provider business mailing address

500 LOS ARBOLES AVE NW APT B
ALBUQUERQUE NM
87107-1288
US

V. Phone/Fax

Practice location:
  • Phone: 623-419-2997
  • Fax: 623-419-2997
Mailing address:
  • Phone: 623-419-2997
  • Fax: 623-419-2997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2025-0852
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: