Larry A Doke, PHD
Individual provider Active NPI Psychologist · Rio Rancho, NM
NPI 1407933906 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1407933906
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 265 (NM)
- Practice address
- 1400 Barbara Loop
Suite I
Rio Rancho, NM 87174-5135 - Phone
- (505) 994-4392
- Fax
- (505) 994-4392
- NPI assigned
- Nov 1, 2006
- 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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 265 | NM | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 265 | NM | Yes |
Addresses
Primary practice location
1400 Barbara Loop
Suite I
Rio Rancho, NM 87174-5135
Mailing address
PO Box 45135
Rio Rancho, NM 87174-5135
Phone (505) 994-4392
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 173089 | Other | MANAGED HEALTH NETWORK | |
| 17736 | Other | BLUE CROSS BLUE SHIELD | |
| 100601 | Other | NM | VALUE OPTIONS OF NM |
| N8677 | Medicaid | NM | |
| 42761 | Other | PRESBYTERIAN HEALTH PLAN | |
| 2001884 | Other | CIGNA BEHAVIORAL HEALTH | |
| 9872 | Other | LOVELACE HEALTH PLAN |
Other providers in Rio Rancho, NM
- Charlene I. Dobbins
- Danielle L Dobbs
- Lauren Docherty
- Keenan Alan Dodd
- Shaun Philip Dodson
- Frank Dominguez
- Gabriella Dominguez
- Jaclyn Dominguez
- Selena Maria Dominguez
- Christine Marie Donovan
All providers in Rio Rancho, NM · Psychologist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.