Healthcare Provider Details

I. General information

NPI: 1558060343
Provider Name (Legal Business Name): FRANCELIA TREJO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2023
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 CENTRAL AVE NW STE F1
ALBUQUERQUE NM
87105-1669
US

IV. Provider business mailing address

8001 MACNISH DR NE
ALBUQUERQUE NM
87109-6475
US

V. Phone/Fax

Practice location:
  • Phone: 505-843-7172
  • Fax:
Mailing address:
  • Phone: 210-417-8880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDB-2025-0168
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: