Active NPI
Optimal Wellness Journey
- Psychiatric/Mental Health Nurse Practitioner
- Albuquerque, NM
National Provider Identifier
1053947408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | |||
| Psychiatric/Mental Health Nurse Practitioner | 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 DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Santa Fe, NM
- NPI 1386197507
Psychiatric/Mental Health
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.