Healthcare Provider Details

I. General information

NPI: 1992073217
Provider Name (Legal Business Name): FRANCIS 'CISCO' ARTHUR MULDEZ LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2011
Last Update Date: 09/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2112 MAIN STREET NE SUITE A
LOS LUNAS NM
87031
US

IV. Provider business mailing address

2441 CABEZON BLVD SE
RIO RANCHO NM
87124
US

V. Phone/Fax

Practice location:
  • Phone: 505-916-5900
  • Fax: 505-916-5901
Mailing address:
  • Phone: 505-717-1155
  • Fax: 505-717-1473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0106531
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: