Healthcare Provider Details

I. General information

NPI: 1205776309
Provider Name (Legal Business Name): ABYGAIL JARAMILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 HIGHWAY 314 NORTH WEST
LOS LUNAS NM
87031-0000
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: 505-359-3239
Mailing address:
  • Phone: 505-944-6626
  • Fax: 505-359-3239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: