Healthcare Provider Details

I. General information

NPI: 1306279799
Provider Name (Legal Business Name): MJ VARGAS CONTRERAS CD (DONA), BA, RYT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2013
Last Update Date: 08/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 TRUCHAS DR NE APT 215
ALBUQUERQUE NM
87109-3876
US

IV. Provider business mailing address

5800 TRUCHAS DR NE APT 215
ALBUQUERQUE NM
87109-3876
US

V. Phone/Fax

Practice location:
  • Phone: 505-506-4340
  • Fax:
Mailing address:
  • Phone: 505-506-4340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: