Active NPI
Paul Peloquin
- Clinical Psychologist
- Albuquerque, NM
National Provider Identifier
1609301142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1181
- Practice address
- 2425 San Pedro Dr NE
Suiite J
Albuquerque, NM 87110-4077 - Phone
- (505) 850-6072
- Fax
- (505) 256-3600
- NPI assigned
- Apr 21, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1181 | NM | Primary |
Addresses
Primary practice location
2425 San Pedro Dr NE
Suiite J
Albuquerque, NM 87110-4077
Mailing address
PO Box 37068
Albuquerque, NM 87176-7068
Phone (505) 850-6072
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 |
|---|---|---|---|
| 1181 | NM | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492732800000",
"number": "1609301142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 37068",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871767068",
"telephone_number": "505-850-6072",
"fax_number": "505-256-3600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 SAN PEDRO DR NE",
"address_2": "SUIITE J",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871104077",
"telephone_number": "505-850-6072",
"fax_number": "505-256-3600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELOQUIN",
"first_name": "PAUL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-04-21",
"last_updated": "2017-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NM",
"license": "1181",
"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 Apr 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.