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General NPI Number Information
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NPI Number | 1801993480
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Entity Type | Organization
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Legal Business Name | ADAMS BEJARANO, LLC
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Dates
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Enumeration Date | 09/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 453 CERRILLOS RD
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City | SANTA FE
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State | NM
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Zip | 87501-3784
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Country | US
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Telephone | 505-690-4797
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Fax | 505-989-8683
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Provider Business Mailing Address
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Address Line | PO BOX 31428
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City | SANTA FE
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State | NM
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Zip | 87594-1428
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Country | US
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Telephone | 505-690-4797
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Fax | 505-989-8683
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Authorized Official
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Title or Position | OWNER MEMBER
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Name | DR. JAMES HARRISON ADAMS
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Credential | PHD
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Telephone | 505-690-4797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 729
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License Number State | NM
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