Healthcare Provider Details

I. General information

NPI: 1871963017
Provider Name (Legal Business Name): ORALIA QUEZADA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2015
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 S TELSHOR BLVD STE 201B
LAS CRUCES NM
88011-3647
US

IV. Provider business mailing address

177 ASPEN DR
SUNLAND PARK NM
88063-9193
US

V. Phone/Fax

Practice location:
  • Phone: 505-974-5890
  • Fax:
Mailing address:
  • Phone: 915-801-8041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: