Healthcare Provider Details

I. General information

NPI: 1053721308
Provider Name (Legal Business Name): CATHERINE BOYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2014
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2074 GALISTEO ST STE B4
SANTA FE NM
87505-2157
US

IV. Provider business mailing address

1805 ARBOLITOS LN
SANTA FE NM
87506-5009
US

V. Phone/Fax

Practice location:
  • Phone: 505-236-4626
  • Fax: 575-694-6810
Mailing address:
  • Phone: 505-670-8264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD2018-0673
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: