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NPI Code Detail

MEDICARE: STEVEN SANDERSON

MEDICARE: STEVEN SANDERSON
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1144170275
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN SANDERSON
Provider Business Mailing Address
First Line : 3415 BATAAN MEMORIAL W
Second Line :
City : LAS CRUCES
State : NM
Zip : 88012-5012
Country : US
Telephone Number : 505-392-3482
Fax Number :
Provider Business Practice Location Address
First Line : 3621 MARION LN
Second Line :
City : LAS CRUCES
State : NM
Zip : 88012-7579
Country : US
Telephone Number : 575-520-6074
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2026
Last Update Date : 01/29/2026

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