Desiree Nicole Bustamantes, SCHOOL PSYCH INTERN
Individual provider Active NPI School Psychologist · Deming, NM
NPI 1699324525 · NPPES record last updated Sep 4, 2019
Key facts
- NPI
- 1699324525
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- License
- 393374 (NM)
- Practice address
- 310 W Elm St
Deming, NM 88030-4123 - Phone
- (575) 546-0427
- NPI assigned
- Sep 4, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 393374 | NM | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Regional Education Cooperative | Current |
Accepting new patients |
Locations
1321 E Poplar St
Deming, NM 88030
Phone 5755465951 ext. 3005
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 393374 | NM | Yes |
Addresses
Primary practice location
310 W Elm St
Deming, NM 88030-4123
Mailing address
1321 E Poplar St
Deming, NM 88030-4807
Phone (575) 546-5951
Other providers in Deming, NM
- Kathleen Ann Brown
- Summer Bunting
- Elizabeth A Burr
- Erin Elizabeth Busby
- Chrystal Bustamante
- Abraham Bustillos
- James Aaron Butz
- Michael Calderon Jr.
- Mary Ann Calvillo
- Hilda A Camunez
All providers in Deming, NM · School 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 Sep 4, 2019. 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.