Organization Active NPI

Juan N Sosa PHD PA

  • Community/Behavioral Health Agency
  • Las Cruces, NM
National Provider Identifier
1083962385
Registry record updated Aug 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
163 Issued in NM
Legal business name
JUAN N SOSA PHD PA
Practice address
1155 S Telshor Blvd
Suite 200
Las Cruces, NM 88011-1009
Phone
(575) 522-8002
Fax
(575) 522-8027
NPI assigned
Aug 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2012

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

Authorized official

Name
Juan N Sosa, PHD
Title
Owner
Phone
(575) 522-8002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 163 NM Primary

Addresses

Primary practice location

1155 S Telshor Blvd
Suite 200
Las Cruces, NM 88011-1009

Mailing address

1155 S Telshor Blvd
Suite 200
Las Cruces, NM 88011-1009
Phone (575) 522-8002

Other identifiers 1

IdentifierTypeStateIssuer
N5806MedicaidNM

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1345161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345161600000",
    "number": "1083962385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 S TELSHOR BLVD",
            "address_2": "SUITE 200",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880111009",
            "telephone_number": "575-522-8002",
            "fax_number": "575-522-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 S TELSHOR BLVD",
            "address_2": "SUITE 200",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880111009",
            "telephone_number": "575-522-8002",
            "fax_number": "575-522-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUAN N SOSA PHD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-17",
        "last_updated": "2012-08-17",
        "status": "A",
        "authorized_official_last_name": "SOSA",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-522-8002",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NM",
            "license": "163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N5806",
            "state": "NM"
        }
    ],
    "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 Aug 17, 2012; 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.