Healthcare Provider Details

I. General information

NPI: 1811840200
Provider Name (Legal Business Name): VILMA LIZ ESCALERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2026
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 HIGHWAY 314 NE
LOS LUNAS NM
87031-8506
US

IV. Provider business mailing address

PO BOX 3372
LOS LUNAS NM
87031-3372
US

V. Phone/Fax

Practice location:
  • Phone: 505-944-6626
  • Fax:
Mailing address:
  • Phone: 505-944-6626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: