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General NPI Number Information
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NPI Number | 1841113461
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Entity Type | Organization
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Legal Business Name | HIGH DESERT OPTIMAL NEUROFEEDBACK
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Dates
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Enumeration Date | 07/31/2026
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Last Update Date | 07/31/2026
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Provider Practice Location Address
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Address Line | 1800 OLD PECOS TRL
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City | SANTA FE
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State | NM
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Zip | 87505-4759
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Country | US
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Telephone | 415-596-1870
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Fax |
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Provider Business Mailing Address
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Address Line | 4204 VUELTA COLORADA
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City | SANTA FE
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State | NM
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Zip | 87507-7290
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Country | US
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Telephone | 415-596-1870
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JULIETA OZAN
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Credential | LMFT
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Telephone | 415-596-1870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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