Individual provider Active NPI

Juliana Victoria Vidal, SLP

  • Speech-Language Pathologist
  • Las Cruces, NM
National Provider Identifier
1073456406
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SAH-2026-0057 Issued in NM
Practice address
576 N Telshor Blvd
Las Cruces, NM 88011-8223
Phone
(575) 515-0101
Fax
(505) 334-1999
NPI assigned
Apr 10, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SAH-2026-0057 NM Primary

Addresses

Primary practice location

576 N Telshor Blvd
Las Cruces, NM 88011-8223

Mailing address

7849 Tramway Blvd NE Ste a
Albuquerque, NM 87122-2529
Phone (505) 895-9381

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260420000785 NM Practitioner - Qualified Speech Language Pathologist 2264908052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balanced Physical Therapy and Wellness LLCGroup PAC ID 9032427513, 50 clinicians

Practice addresses (Care Compare)

576 N Telshor Blvd
Las Cruces, NM 88011-8223
Phone (575) 515-0101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SAH-2026-0057NMMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Physical Therapy and Wellness, LLC CurrentSince Apr 15, 2026 Accepting new patients

Locations

7849 Tramway Blvd NE
Ste A
Albuquerque, NM 87122
Phone (505) 821-3831

576 N Telshor Blvd
Las Cruces, NM 88011
Phone (575) 515-0101

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1775779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1073456406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7849 TRAMWAY BLVD NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871222529",
            "telephone_number": "505-895-9381",
            "fax_number": "505-213-2958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 N TELSHOR BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118223",
            "telephone_number": "575-515-0101",
            "fax_number": "505-334-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDAL",
        "first_name": "JULIANA",
        "middle_name": "VICTORIA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-10",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "SAH-2026-0057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.