Healthcare Provider Details

I. General information

NPI: 1477980779
Provider Name (Legal Business Name): ANGEL ANYA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2013
Last Update Date: 07/22/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 CORRIZ DR SW
ALBUQUERQUE NM
87121-8311
US

IV. Provider business mailing address

4609 SUNSHINE PL SW
ALBUQUERQUE NM
87105-6440
US

V. Phone/Fax

Practice location:
  • Phone: 505-836-0623
  • Fax: 505-848-9468
Mailing address:
  • Phone: 505-220-6332
  • Fax: 505-848-9468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberM-07837
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: