Individual provider Active NPI

Alfred J Valdez, SLP

  • Speech-Language Pathologist
  • Albuquerque, NM
National Provider Identifier
1790901577
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
102 Issued in NM
Practice address
1700 Sunshine Ter SE
Lowell Es
Albuquerque, NM 87106-3906
Phone
(505) 764-2011
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 102 NM Primary

Addresses

Primary practice location

1700 Sunshine Ter SE
Lowell Es
Albuquerque, NM 87106-3906

Mailing address

1700 Sunshine Ter SE
Lowell Es
Albuquerque, NM 87106-3906
Phone (505) 764-2011

Other identifiers 1

IdentifierTypeStateIssuer
L 0967MedicaidNM

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

LicenseStateTypeSpecialty
102NMMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1790901577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SUNSHINE TER SE",
            "address_2": "LOWELL ES",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871063906",
            "telephone_number": "505-764-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SUNSHINE TER SE",
            "address_2": "LOWELL ES",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871063906",
            "telephone_number": "505-764-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDEZ",
        "first_name": "ALFRED",
        "middle_name": "J",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L 0967",
            "state": "NM"
        }
    ],
    "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 Jul 9, 2007; 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.