Healthcare Provider Details

I. General information

NPI: 1528866977
Provider Name (Legal Business Name): ALBERTYN PINO CPSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 TRUMAN ST NE
ALBUQUERQUE NM
87110-6443
US

IV. Provider business mailing address

625 TRUMAN ST NE
ALBUQUERQUE NM
87110-6443
US

V. Phone/Fax

Practice location:
  • Phone: 505-705-3340
  • Fax: 505-265-9576
Mailing address:
  • Phone: 505-705-3340
  • Fax: 505-265-9576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number1220
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: