Luciano Calabaza, LADAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

3697 Issued in NM

Practice address

10 Tesuque St
Santo Domingo Pueblo, NM 87052-9998

Phone

(505) 465-2733

Fax

(505) 465-0433

NPI assigned

Jul 18, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Santo Domingo Pueblo

  • Community/Behavioral Health Agency
  • Santo Domingo Pueblo, NM
  • NPI 1396944211
  NPD (past)

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1306046487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 TESUQUE ST",
            "city": "SANTO DOMINGO PUEBLO",
            "state": "NM",
            "postal_code": "870529998",
            "telephone_number": "505-465-2733",
            "fax_number": "505-465-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 TESUQUE ST",
            "city": "SANTO DOMINGO PUEBLO",
            "state": "NM",
            "postal_code": "870529998",
            "telephone_number": "505-465-2733",
            "fax_number": "505-465-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALABAZA",
        "first_name": "LUCIANO",
        "name_prefix": "Mr.",
        "credential": "LADAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "3697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shane Benally, OD
• Theresa Brown-Doonquah, DDS
• Tina T Bui-Burgos, CNP
• Estefanita L. Calabaza
• George Lucas Calabaza
• Michael Calabaza
• Kanisha Chavez
• Janine Chinana, RN
• Elka M. Coriz
• Jordana Kelsey Coriz, CCSS

• Addiction (Substance Use Disorder) Counselor in Santo Domingo Pueblo, NM
• Providers in Santo Domingo Pueblo, NM by specialty
• Addiction (Substance Use Disorder) Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.