Sandra Sue Richardson
Individual provider Active NPI Community Health Worker · Penasco, NM
NPI 1033880877 · NPPES record last updated Sep 22, 2021
Key facts
- NPI
- 1033880877
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- Practice address
- 201-A Pueblo View Road
Picuris Pueblo
Penasco, NM 87553 - Phone
- (575) 779-6112
- NPI assigned
- Sep 22, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Picuris Pueblo | Community Health Worker | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Yes |
Addresses
Primary practice location
201-A Pueblo View Road
Picuris Pueblo
Penasco, NM 87553
Mailing address
PO Box 127
Penasco, NM 87553-0127
Phone (575) 779-6112
Other providers in Penasco, NM
- Mia G Pacheco
- Penasco Independent Schools
- Picuris Medical Center
- Picuris Medical Center
- Picuris Pueblo
- Kay-Mani Riely
- Roberta Rodriguez
- Lori D Romero
- Arturo D Sisneros
- Natasha Ann Snake
All providers in Penasco, NM · Community Health Worker in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.