Desert Bloom Telepsych Services LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

CNP-01597 Issued in NM

Legal business name

DESERT BLOOM TELEPSYCH SERVICES LLC

Practice address

8605 Vineyard Ridge Rd NE
Albuquerque, NM 87122-2623

Phone

(505) 620-6389

NPI assigned

Apr 7, 2016

Organization subpart

No

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

Authorized official

Name

Debra Marie Stanger, CNP

Title

Pmhnp-BC Sole Owner

Phone

(505) 856-2262

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459987200000",
    "number": "1336503176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8605 VINEYARD RIDGE RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871222623",
            "telephone_number": "505-620-6389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8605 VINEYARD RIDGE RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871222623",
            "telephone_number": "505-620-6389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT BLOOM TELEPSYCH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-07",
        "last_updated": "2016-04-07",
        "status": "A",
        "authorized_official_last_name": "STANGER",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PMHNP-BC  SOLE OWNER",
        "authorized_official_telephone_number": "505-856-2262",
        "authorized_official_credential": "CNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "CNP-01597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78935784",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerard Louis Desantis, DMD
• Lani Marie Desaulniers, MD
• Christina Lilly Deschiney, PA
• Desert Bloom Healing LLC
• Desert Bloom Health Collaborative LLC
• Desert Health Endocrinology
• Desert Health, LLC
• Desert Island Services
• Desert Lily Psychiatry
• Desert Magnolia Therapy

• Psychiatric/Mental Health Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2016; 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.