Healthcare Provider Details

I. General information

NPI: 1356447932
Provider Name (Legal Business Name): WARREN M. STEINMAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1807 2ND ST SUITE 40
SANTA FE NM
87505-3499
US

IV. Provider business mailing address

PO BOX 274
SANTA FE NM
87504-0274
US

V. Phone/Fax

Practice location:
  • Phone: 505-983-7191
  • Fax: 505-466-4069
Mailing address:
  • Phone: 505-983-7191
  • Fax: 505-466-4069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number322
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: