Healthcare Provider Details
I. General information
NPI: 1932607967
Provider Name (Legal Business Name): BRIANDA SAENZ VASQUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/24/2018
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
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
- Phone: 505-273-6300
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: