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Contact Information

JONELLE BACA, CSW
2503 RIDGE RUNNER RD
LAS VEGAS, NM87701-4972
 Phone: 505-454-8265
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Counselor

101Y00000X
Indicates primary specialty

NPI Profile & details for JONELLE BACA · (Female)

NPI Number 1396078333
Status Active
Credentials CSW
Entity Individual
Enumeration date 09/09/2009
Last updated 06/25/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • NM Medicaid L7094
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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