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Contact Information

TANA CHAVEZ
P.O BOX 4339
SAN FELIPE PUEBLO, NM87001
 Phone: 505-771-1463
 Fax: 505-771-9994
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Other Service Providers

175T00000X
 

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for TANA CHAVEZ · (Female)

NPI Number 1760065817
Status Active
Credentials
Entity Individual
Enumeration date 05/05/2021
Last updated 04/09/2024 - About 2 years ago
Sole proprietor 1 Yes
Identifiers
  • NM License # 1115
  • NM License # CSA0223991
  • NM Medicaid 21720827
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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