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NPI Code Detail

MEDICARE: SUNRISE CLINICS

MEDICARE: SUNRISE CLINICS
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
1261QF0400XFederally Qualified Health Center (FQHC)
21041S0200XSchool Social Worker
3261QS1000XStudent Health Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194408625
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNRISE CLINICS
Provider Business Mailing Address
First Line : 117 CAMINO DE VIDA STE 300
Second Line :
City : SANTA ROSA
State : NM
Zip : 88435-2267
Country : US
Telephone Number : 575-472-4311
Fax Number : 877-651-0289
Provider Business Practice Location Address
First Line : 1024 S PACIFIC ST
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-3415
Country : US
Telephone Number : 505-426-2599
Fax Number : 877-651-0289
Authorized Official
Title or Position : DIRECTOR OF HR
Name : JESSICA SANCHEZ
Credential :
Telephone Number : 575-472-4311
Provider Enumeration Date : 08/10/2023
Last Update Date : 01/28/2026

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Directions to “SUNRISE CLINICS ” Practice Location

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