Healthcare Provider Details

I. General information

NPI: 1770406282
Provider Name (Legal Business Name): ANGELICA ALVARADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 N LINAM ST
HOBBS NM
88240-6037
US

IV. Provider business mailing address

2916 N SELMAN ST
HOBBS NM
88240-2000
US

V. Phone/Fax

Practice location:
  • Phone: 575-392-0802
  • Fax:
Mailing address:
  • Phone: 575-392-0802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License NumberG2111
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: