Healthcare Provider Details

I. General information

NPI: 1144147869
Provider Name (Legal Business Name): MATTHEW JOSEPH LOVATO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 PROSPECT PL NE
ALBUQUERQUE NM
87110-4348
US

IV. Provider business mailing address

202 QUINCY ST NE APT 6
ALBUQUERQUE NM
87108-1349
US

V. Phone/Fax

Practice location:
  • Phone: 505-304-3305
  • Fax:
Mailing address:
  • Phone: 505-249-6746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: