NPIMap

Organization Active NPI

Burbanomendoza, LLC

Doing business as Sandia Psychiatry

  • Psychiatry Physician
  • Albuquerque, NM
National Provider Identifier
1629524301
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD2013-0964 Issued in NM
Legal business name
BURBANOMENDOZA, LLC
Doing business as
Sandia Psychiatry
Practice address
3900 Juan Tabo Blvd NE
Suite 4
Albuquerque, NM 87111-3984
Phone
(505) 298-1010
Fax
(505) 298-3939
NPI assigned
Aug 31, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2016

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

Authorized official

Name
Dr. Alicia Burbano, M.D.NPI 1083857247
Title
Member
Phone
(409) 454-4466

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X MD2013-0964 NM Primary

Addresses

Primary practice location

3900 Juan Tabo Blvd NE
Suite 4
Albuquerque, NM 87111-3984

Mailing address

3900 Juan Tabo Blvd NE
Suite 4
Albuquerque, NM 87111-3984
Phone (505) 298-1010

Other names 1

  • Sandia Psychiatry Doing business as

National Provider Directory

National Provider Directory

Locations

3900 Juan Tabo Blvd NE
Ste 4
Albuquerque, NM 87111
Phone (505) 298-1010

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472601600000",
    "number": "1629524301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 JUAN TABO BLVD NE",
            "address_2": "SUITE 4",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113984",
            "telephone_number": "505-298-1010",
            "fax_number": "505-298-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 JUAN TABO BLVD NE",
            "address_2": "SUITE 4",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113984",
            "telephone_number": "505-298-1010",
            "fax_number": "505-298-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURBANOMENDOZA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-08-31",
        "status": "A",
        "authorized_official_last_name": "BURBANO",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "409-454-4466",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NM",
            "license": "MD2013-0964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sandia Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 31, 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.