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
1	104100000X	Social Worker
2	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1427851179
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	:	2020 7TH ST
Second Line	:
City	:	LAS VEGAS
State	:	NM
Zip	:	87701-4958
Country	:	US
Telephone Number	:	505-587-1050
Fax Number	:	877-553-1272

Authorized Official
Title or Position	:	HUMAN RESOURCES
Name	:	JESSICA SANCHEZ
Credential	:	CREDENTIALING
Telephone Number	:	575-472-4311

Provider Enumeration Date	:	03/28/2025
Last Update Date	:	03/28/2025

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Directions to “SUNRISE CLINICS ” Practice Location

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