| Hipocampo Llc | |
|
1330 San Pedro Dr Ne Ste 108 Albuquerque NM 87110-6744 | |
| (505) 209-9227 | |
| (505) 273-3115 |
| Full Name | Hipocampo Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1330 San Pedro Dr Ne Ste 108, Albuquerque, New Mexico |
| Authorized Official Name and Position | Dulce Rodriguez (OWNER) |
| Authorized Official Contact | 5052099227 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hipocampo Llc Po Box 72922 Albuquerque NM 87195-2922 Ph: () - | Hipocampo Llc 1330 San Pedro Dr Ne Ste 108 Albuquerque NM 87110-6744 Ph: (505) 209-9227 |
| NPI Number | 1073203253 |
|---|---|
| Provider Enumeration Date | 05/10/2023 |
| Last Update Date | 09/25/2023 |
| Certification Date | 09/25/2023 |
| Medicare PECOS PAC ID | 7012369226 |
|---|---|
| Medicare Enrollment ID | O20240123003087 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073203253 | NPI | - | NPPES |
| 35479728 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Dulce Maria Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538687694 PECOS PAC ID: 2062864671 Enrollment ID: I20240119000845 |
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