Healthcare Provider Details

I. General information

NPI: 1306781588
Provider Name (Legal Business Name): YESENIA MONTOYA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 ESTHER TRL
SANTA TERESA NM
88008-9347
US

IV. Provider business mailing address

121 ESTHER TRL
SANTA TERESA NM
88008-9347
US

V. Phone/Fax

Practice location:
  • Phone: 915-471-3249
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1227256
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: