| Xochihuan Traditional Healing And Psychotheraphy, Llc | |
|
1006 Jane St Ne Albuquerque NM 87112-5612 | |
| (505) 485-3060 | |
| Not Available |
| Full Name | Xochihuan Traditional Healing And Psychotheraphy, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1006 Jane St Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Jaysa P Jones (OWNER) |
| Authorized Official Contact | 5054506690 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Xochihuan Traditional Healing And Psychotheraphy, Llc 1006 Jane St Ne Albuquerque NM 87112-5612 Ph: (505) 485-3060 | Xochihuan Traditional Healing And Psychotheraphy, Llc 1006 Jane St Ne Albuquerque NM 87112-5612 Ph: (505) 485-3060 |
| NPI Number | 1124680319 |
|---|---|
| Provider Enumeration Date | 07/08/2019 |
| Last Update Date | 03/30/2020 |
| Certification Date | 03/30/2020 |
| Medicare PECOS PAC ID | 7517394125 |
|---|---|
| Medicare Enrollment ID | O20200220001504 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124680319 | NPI | - | NPPES |
| 27174751 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jaysa P Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477817955 PECOS PAC ID: 7719275866 Enrollment ID: I20161005002684 |
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