Healthcare Provider Details

I. General information

NPI: 1629863477
Provider Name (Legal Business Name): DR. CLAUDIA A RAPHAEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2025
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 CERRILLOS RD STE 737
SANTA FE NM
87507-2689
US

IV. Provider business mailing address

31 BOSQUE LOOP
SANTA FE NM
87508-2231
US

V. Phone/Fax

Practice location:
  • Phone: 240-535-7909
  • Fax:
Mailing address:
  • Phone: 240-535-7909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: