Healthcare Provider Details

I. General information

NPI: 1457275521
Provider Name (Legal Business Name): SUNRISE CLINICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

898 NM STATE HWY 304
VEGUITA NM
87062
US

IV. Provider business mailing address

898 NM STATE HWY 304
VEGUITA NM
87062
US

V. Phone/Fax

Practice location:
  • Phone: 505-966-2400
  • Fax:
Mailing address:
  • Phone: 505-966-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JESSICA SANCHEZ
Title or Position: HUMAN RESOURCES
Credential: CREDENTIALING
Phone: 575-472-4311