NPIMap

Organization Active NPI

Deer Oaks Southwest

  • Clinical Psychologist
  • Albuquerque, NM
National Provider Identifier
1831354620
Registry record updated Feb 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
DEER OAKS SOUTHWEST
Practice address
1112 San Pedro Dr NE
Suite 222
Albuquerque, NM 87110-6724
Phone
(505) 254-3505
Fax
(210) 593-9863
NPI assigned
Jul 22, 2008
Last updated
Feb 5, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2009

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

Authorized official

Name
Paul Alan Boskind, PH.D.
Title
Ceo
Phone
(210) 615-3472

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

1112 San Pedro Dr NE
Suite 222
Albuquerque, NM 87110-6724

Mailing address

7272 Wurzbach Rd
Suite 601
San Antonio, TX 78240-4801
Phone (210) 615-3472

Other identifiers 1

IdentifierTypeStateIssuer
382270MedicaidAZ

National Provider Directory

National Provider Directory

Locations

5025 N Central Ave
Ste 700
Phoenix, AZ 85012
Phone (602) 253-6833

1112 San Pedro Dr NE
Albuquerque, NM 87110
Phone (505) 254-3505

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233792000000",
    "number": "1831354620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7272 WURZBACH RD",
            "address_2": "SUITE 601",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782404801",
            "telephone_number": "210-615-3472",
            "fax_number": "210-593-9863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 SAN PEDRO DR NE",
            "address_2": "SUITE 222",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871106724",
            "telephone_number": "505-254-3505",
            "fax_number": "210-593-9863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEER OAKS SOUTHWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-22",
        "last_updated": "2009-02-05",
        "status": "A",
        "authorized_official_last_name": "BOSKIND",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "210-615-3472",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "382270",
            "state": "AZ"
        }
    ],
    "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 Feb 5, 2009; 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.