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NPI Code Detail

MEDICARE: JALENE HERRON PHD

MEDICARE: JALENE HERRON PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPSY-2025-0046NM

General Provider Information

NPI Number : 1063086817
Entity Type Code : Individual
Provider Name (Legal Business Name) : JALENE HERRON PHD
Provider Business Mailing Address
First Line : 1 UNIVERSITY OF NEW MEXICO
Second Line : MSC09-5030
City : ALBUQUERQUE
State : NM
Zip : 87131-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2211 LOMAS BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87106-2719
Country : US
Telephone Number : 505-272-2237
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2021
Last Update Date : 06/23/2026

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