Organization Active NPI

Optimal Wellness Journey

  • Psychiatric/Mental Health Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1053947408
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
OPTIMAL WELLNESS JOURNEY
Practice address
4801 Lang Ave NE Ste 110
Albuquerque, NM 87109-4475
Phone
(505) 303-3383
Fax
(505) 672-7924
NPI assigned
Mar 18, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tina Folden, NP
Title
Owner
Phone
(770) 605-6491

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

4801 Lang Ave NE Ste 110
Albuquerque, NM 87109-4475

Mailing address

4801 Lang Ave NE Ste 110
Albuquerque, NM 87109-4475
Phone (505) 303-3383

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1584489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1053947408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 LANG AVE NE STE 110",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094475",
            "telephone_number": "505-303-3383",
            "fax_number": "505-672-7924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 LANG AVE NE STE 110",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094475",
            "telephone_number": "505-303-3383",
            "fax_number": "505-672-7924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL WELLNESS JOURNEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-18",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-23",
        "status": "A",
        "authorized_official_last_name": "FOLDEN",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-605-6491",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.