Individual provider Active NPI

Jacqueline Holguin, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1669235453
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
77799 Issued in NM
Practice address
249 Canyon Terrace Dr
El Paso, TX 79902
Phone
(915) 803-5606
NPI assigned
Feb 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 77799 NM Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1141078 TX

Addresses

Primary practice location

249 Canyon Terrace Dr
El Paso, TX 79902

Mailing address

385 Calle de Alegra Ste a
Las Cruces, NM 88005-3423
Phone (575) 526-1105

Other practice location 1

760 N Motel Blvd
Las Cruces, NM 88007-4169
Phone (575) 527-7975

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250227003543 NM Practitioner - Nurse Practitioner 6507386927 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
77799NMMDPsychiatric/Mental Health Nurse Practitioner
1141078TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de Familia, Incorporated Current Accepting new patients
La Clinica de Familia, Incorporated CurrentSince Feb 17, 2025 Accepting new patients
La Clinica de Familia, Incorporated CurrentSince Feb 17, 2025 Accepting new patients

Locations

826 Anthony Dr
Anthony, NM 88021
Phone (575) 201-5135

760 N Motel Blvd
Ste Ac
Las Cruces, NM 88007

535 S Miranda St
Las Cruces, NM 88005

385 Calle de Alegra
Bldg A
Las Cruces, NM 88005
Phone 57552611052444

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1669235453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 CALLE DE ALEGRA STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053423",
            "telephone_number": "575-526-1105",
            "fax_number": "575-524-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 CANYON TERRACE DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79902",
            "telephone_number": "915-803-5606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760 N Motel Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880074169",
            "country_code": "US",
            "telephone_number": "575-527-7975",
            "fax_number": "575-674-2861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLGUIN",
        "first_name": "JACQUELINE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "77799",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1141078",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.