| Tierra Alta Neuropsychology Llc | |
|
1911 5th St Ste 206 Santa Fe NM 87505-5403 | |
| (505) 695-5675 | |
| Not Available |
| Full Name | Tierra Alta Neuropsychology Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 1911 5th St Ste 206, Santa Fe, New Mexico |
| Authorized Official Name and Position | Jennifer Monzones (OWNER AND CLINICAL NEUROPSYCHOLOGIS) |
| Authorized Official Contact | 9178057945 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tierra Alta Neuropsychology Llc 1911 5th St Ste 206 Santa Fe NM 87505-5403 Ph: () - | Tierra Alta Neuropsychology Llc 1911 5th St Ste 206 Santa Fe NM 87505-5403 Ph: (505) 695-5675 |
| NPI Number | 1245925940 |
|---|---|
| Provider Enumeration Date | 04/07/2023 |
| Last Update Date | 06/12/2024 |
| Certification Date | 06/12/2024 |
| Medicare PECOS PAC ID | 2567829401 |
|---|---|
| Medicare Enrollment ID | O20230607002743 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245925940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Jennifer G Monzones |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538578737 PECOS PAC ID: 2264654631 Enrollment ID: I20141119002258 |
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