Alicia Michele Burbano

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD2013-0964 Issued in NM

Practice address

3900 Juan Tabo Blvd NE
Suite 4
Albuquerque, NM 87111-3984

Phone

(505) 298-1010

Fax

(505) 298-3939

NPI assigned

Apr 16, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Burbanomendoza, LLC

  • Psychiatry Physician
  • Albuquerque, NM
  • NPI 1629524301
  NPD Authorized official
• Life Change Psychotherapy Institute, PC

  • Professional Counselor
  • Albuquerque, NM
  • NPI 1740409135
  NPD (past)

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

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491609600000",
    "number": "1083857247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 JUAN TABO BLVD NE",
            "address_2": "SUITE 4",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113984",
            "telephone_number": "505-298-1010",
            "fax_number": "505-298-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 JUAN TABO BLVD NE",
            "address_2": "SUITE 4",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113984",
            "telephone_number": "505-298-1010",
            "fax_number": "505-298-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURBANO",
        "first_name": "ALICIA",
        "middle_name": "MICHELE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-16",
        "last_updated": "2017-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NM",
            "license": "MD2013-0964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "61625728",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shawn Bunton
• Michelle Bunzel, PT
• Reynold Bunzel, OT
• Kristen Ann Buongiorno, LCSW
• Dianna Burbank
• Burbanomendoza, LLC
• Ann Elaine Burcham, RN
• Violet Rose Burchfield
• Esteban Burciaga-Tena, PHARMD
• Nicole Burciaga

• Psychiatry Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Psychiatry Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2017; 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.