Healthcare Provider Details

I. General information

NPI: 1609358597
Provider Name (Legal Business Name): CATALINA NUNEZ LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2018
Last Update Date: 09/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S CAMINO DEL PUEBLO
BERNALILLO NM
87004-6276
US

IV. Provider business mailing address

1041 FESTIVAL CT NW
LOS LUNAS NM
87031-8553
US

V. Phone/Fax

Practice location:
  • Phone: 505-865-3350
  • Fax:
Mailing address:
  • Phone: 505-504-5190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberM-10078
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: