Healthcare Provider Details

I. General information

NPI: 1114861473
Provider Name (Legal Business Name): FATIMA CONCEPCION TORRES VERDI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 12455
ALBUQUERQUE NM
87195-0455
US

IV. Provider business mailing address

1317 ISLETA BLVD SW
ALBUQUERQUE NM
87105-4035
US

V. Phone/Fax

Practice location:
  • Phone: 505-312-7296
  • Fax: 505-212-5975
Mailing address:
  • Phone: 505-312-7296
  • Fax: 505-212-5975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: