Healthcare Provider Details

I. General information

NPI: 1841102035
Provider Name (Legal Business Name): DARRYL EUGENE MONTOYA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2411 CABEZON BLVD SE STE 101
RIO RANCHO NM
87124-1514
US

IV. Provider business mailing address

1851 VALLEY RD SW
ALBUQUERQUE NM
87105-4843
US

V. Phone/Fax

Practice location:
  • Phone: 505-336-0238
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWB-2026-1285
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: