MEDICARE: EDEN BORUNDA LMSW

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	X-12248	NM

General Provider Information

NPI Number	:	1659039295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDEN BORUNDA LMSW

Provider Business Mailing Address
First Line	:	9201 MONTGOMERY BLVD NE BLDG 1
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-2468
Country	:	US
Telephone Number	:	505-588-7571
Fax Number	:

Provider Business Practice Location Address
First Line	:	9201 MONTGOMERY BLVD NE BLDG 1
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-2468
Country	:	US
Telephone Number	:	505-588-7571
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2021
Last Update Date	:	06/26/2026

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Directions to “ EDEN BORUNDA LMSW” Practice Location

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