Healthcare Provider Details

I. General information

NPI: 1548191869
Provider Name (Legal Business Name): JOHN ALAN WARFORD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 MOUNTAIN RD NW
ALBUQUERQUE NM
87104-1359
US

IV. Provider business mailing address

701A KATHRYN AVE
SANTA FE NM
87505-1037
US

V. Phone/Fax

Practice location:
  • Phone: 505-557-4656
  • Fax:
Mailing address:
  • Phone: 505-501-9001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: