Active NPI
Janice Alta Juan
- Social Worker
- Albuquerque, NM
National Provider Identifier
1346719440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- X-10622
- Practice address
- 100 Deputy Dean Miera Dr SW
Albuquerque, NM 87151-1000 - Phone
- (505) 839-8974
- NPI assigned
- Nov 19, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | X-10622 | NM | Primary |
Addresses
Primary practice location
100 Deputy Dean Miera Dr SW
Albuquerque, NM 87151-1000
Mailing address
5851 Anderson Ave SE Apt 81
Albuquerque, NM 87108-5413
Phone (505) 239-6106
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X-10622 | NM | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542585600000",
"number": "1346719440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5851 ANDERSON AVE SE APT 81",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871085413",
"telephone_number": "505-239-6106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 DEPUTY DEAN MIERA DR SW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871511000",
"telephone_number": "505-839-8974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUAN",
"first_name": "JANICE",
"middle_name": "ALTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-19",
"last_updated": "2018-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "X-10622",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.