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NPI Code Detail

MEDICARE: DEPPA THERAPY SERVICES P.C.

MEDICARE: DEPPA THERAPY SERVICES P.C.
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
1225X00000XOccupational Therapist249NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952449498
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEPPA THERAPY SERVICES P.C.
Provider Business Mailing Address
First Line : 713 CALIFORNIA ST SE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-3707
Country : US
Telephone Number : 505-265-2168
Fax Number : 505-265-7156
Provider Business Practice Location Address
First Line : 713 CALIFORNIA ST SE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-3707
Country : US
Telephone Number : 505-265-2168
Fax Number : 505-265-7156
Authorized Official
Title or Position : CEO
Name : MS. JOYCEMARIE DEPPA
Credential : OT
Telephone Number : 505-265-2168
Provider Enumeration Date : 02/04/2007
Last Update Date : 08/22/2020

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Directions to “DEPPA THERAPY SERVICES P.C. ” Practice Location

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