Chavez, Tana

Chavez, Tana is an sole proprietor health care provider with primary practice located at P.O Box 4339 , San Felipe Pueblo NM 87001. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Peer Specialist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Other Service Providers / Peer Specialist is her primary health care specialty. Chavez, Tana can be contacted via phone (505) 771-1463.

Contact Information

Primary practice address
P.O Box 4339 San Felipe Pueblo NM 87001
Phone: (505) 771-1463
Fax: (505) 771-9994
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X 1115 New Mexico
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CSA0223991 New Mexico

Profile Details

NPI number 1760065817
LBN Legal business name Chavez, Tana
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 5th, 2021
Last updated Apr 9th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760065817 NPPES
New Mexico MEDICAID 21720827

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