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General NPI Number Information
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NPI Number | 1053238170
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Entity Type | Individual
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Provider Name | JAIMIE SAUCEDO
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Gender | Female
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Dates
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Enumeration Date | 06/30/2026
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Last Update Date | 06/30/2026
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Provider Practice Location Address
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Address Line | 1390 NORTHWESTERN DR
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City | EL PASO
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State | TX
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Zip | 79912-8003
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Country | US
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Telephone | 512-673-0015
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Fax |
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Provider Business Mailing Address
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Address Line | 11532 PORFIRIO PAYAN DR
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City | EL PASO
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State | TX
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Zip | 79934-3197
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Country | US
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Telephone | 512-673-0015
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1024348
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License Number State | TX
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