Healthcare Provider Details

I. General information

NPI: 1225965130
Provider Name (Legal Business Name): VICTORIA NARVAIZ CCHW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 W ALAMEDA ST
SANTA FE NM
87501-1681
US

IV. Provider business mailing address

1691 GALISTEO ST STE D
SANTA FE NM
87505-4781
US

V. Phone/Fax

Practice location:
  • Phone: 505-955-9454
  • Fax: 505-982-6298
Mailing address:
  • Phone: 505-955-9454
  • Fax: 505-982-6298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1871602698
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: