Doctor Name: | JOSE M PADILLA |
NPI Number: | 1003007709 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 3555 |
Business Practice Address: | 735 Don Pasqual Rd Nw Los Lunas, NM - 870318493 |
Business Phone Number: | 5058653350 |
Business Fax Number: | 5058654739 |
Mailing Address: | Po Box 518, LOS LUNAS |
State: | NM |
Postal Code: | 870310518 |
Phone Number: | 5058653350 |
Fax Number: | 5058654739 |
NPI Enumeration Date: | 08/07/2007 |
NPI Last Update Date: | 08/07/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 3555 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |