Healthcare Provider Details

I. General information

NPI: 1376304188
Provider Name (Legal Business Name): DANIEL JOHN SARRAO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2024
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 CANDELARIA RD NE STE B
ALBUQUERQUE NM
87107-1965
US

IV. Provider business mailing address

3301 CANDELARIA RD NE STE B
ALBUQUERQUE NM
87107-1965
US

V. Phone/Fax

Practice location:
  • Phone: 505-273-6300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberCTB-2024-0535
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2024-0231
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: