Luis Manuel Chaveste-Fernandez

Key facts

NPI

1104690544

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Technician 106S00000X

Practice address

12121 NM Highway 14
Cedar Crest, NM 87008

Phone

(575) 202-1117

NPI assigned

Nov 7, 2023

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 7, 2023.

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1104690544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 COLUMBINE AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871132236",
            "telephone_number": "505-202-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12121 NM HIGHWAY 14",
            "city": "CEDAR CREST",
            "state": "NM",
            "postal_code": "87008",
            "telephone_number": "575-202-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVESTE-FERNANDEZ",
        "first_name": "LUIS",
        "middle_name": "MANUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-07",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Crest, NM

• Harry Russell Burger, DO
• Cedar Crest Vision LLC
• Chapters LLC
• Charter Healthcare of Albuquerque, LLC
• May Ying Chau, L.M.T
• Anthony Sheng-Yuan Chuang, DDS
• Chaya Citrin, MC, LMHC
• Jana R. Covell, P.T.
• Rebeca Jazmin Cruz
• Keli Maureen Dersch-Baldonado, LPCC

All providers in Cedar Crest, NM · Behavior Technician in New Mexico