Healthcare Provider Details

I. General information

NPI: 1851702690
Provider Name (Legal Business Name): LINNIE SANCHEZ PADILLA LBSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2014
Last Update Date: 05/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 IDALIA BLDG B
BERNALILLO NM
87004-6303
US

IV. Provider business mailing address

1500 IDALIA BLDG B
BERNALILLO NM
87004-6303
US

V. Phone/Fax

Practice location:
  • Phone: 505-867-2291
  • Fax: 505-867-0107
Mailing address:
  • Phone: 505-867-2291
  • Fax: 505-867-0107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberB3252
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: