Healthcare Provider Details

I. General information

NPI: 1487599973
Provider Name (Legal Business Name): BRENDA GABRIELA VILLALOBOS RODRIQUEZ LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRENDA GABRIELA RODRIGUEZ

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 VALENTINE WAY
SANTA FE NM
87507
US

IV. Provider business mailing address

6601 VALENTINE WAY
SANTA FE NM
87507
US

V. Phone/Fax

Practice location:
  • Phone: 505-470-0151
  • Fax:
Mailing address:
  • Phone: 505-470-0151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWB-2025-0808
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: