DR. MAX MASTELLONE (NPI# 1134278179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134278179 |
| Entity Type | Individual |
| Full Name | DR. MAX MASTELLONE |
| Credential | PH.D. |
| Practice Address |
330 N Campo St Las Cruces NM 88001-3433 |
| Mailing Address |
2615 Cashmere Ct Las Cruces NM 88011-0800 |
| Practice Telephone | 6097065931 |
| Practice Fax Number | 5055216259 |
| Mailing Telephone | 6097065931 |
| Mailing Fax Number | 5055216259 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103TC0700X |
Psychologist Specialization: Clinical |
0953 | NM | Behavioral Health & Social Service Providers |
| X | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
0953 | NM | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 22559302 | 05 | |
| NM | 39980847 | 05 |
| Street Address |
330 N CAMPO ST |
| City | LAS CRUCES |
| State | NM |
| Zip Code | 88001-3433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598710824 | Jacqueline Villalobos | Naturopath | 330 N Campo St, Las Cruces, NM 88001-3433 | 2006-05-24 |
| 1649887092 | Jacqueline Villalobos Nd LLC | Clinic/Center | 330 N Campo St, Las Cruces, NM 88001-3433 | 2020-09-29 |
| 1508482316 | Wellness and Aesthetics LLC | Nurse Practitioner | 330 N Campo St, Las Cruces, NM 88001-3433 | 2020-06-18 |
| 1104442847 | Bella Vida Health Services LLC | Clinic/Center | 330 N Campo St, Las Cruces, NM 88001-3433 | 2020-06-18 |
| 1013300854 | Lisa Noelani Chavez | Social Worker | 330 N Campo St, Las Cruces, NM 88001-3433 | 2015-03-17 |
| 1417360843 | Anna Lopez | Counselor | 330 N Campo St, Las Cruces, NM 88001-3433 | 2014-06-03 |
| 1225448954 | Nick Barneclo,llc | Psychologist | 330 N Campo St, Las Cruces, NM 88001-3433 | 2014-05-02 |
| 1194049841 | Diana Portillo | Nurse Practitioner | 330 N Campo St, Las Cruces, NM 88001-3433 | 2010-03-24 |
| 1568786820 | Rachel Saavedra | Nurse Practitioner | 330 N Campo St, Las Cruces, NM 88001-3433 | 2010-03-16 |
| 1447589569 | Nick Anthony Barneclo | Psychologist | 330 N Campo St, Las Cruces, NM 88001-3433 | 2009-12-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760020044 | Three Crosses Regional Hospital LLC | General Acute Care Hospital | 2560 Samaritan Drive, Las Cruces, NM 88001 | 2019-12-17 |
| 1760961908 | Halcyon Health of The Southwest, LLC | Nurse Practitioner | 1355 California Ave Ste B, Las Cruces, NM 88001 | 2018-08-08 |
| 1255818530 | Lago Claro, LLC | Counselor | 2410 S. Espina St, Las Cruces, NM 88001 | 2018-07-19 |
| 1407371818 | Elijah Daniel Perez | Behavior Technician | 1535 Myrtle Ave, Las Cruces, NM 88001 | 2017-08-07 |
| 1982128641 | Krystal Marie Ruiz | Psychologist | 505 S. Main, Ste. 249, Las Cruces, NM 88001 | 2017-08-03 |
| 1457886913 | Mathew Petersen Dds PC | Dentist | 2001 E. Lohman Ave. Suite 121, Las Cruces, NM 88001 | 2017-04-21 |
| 1801343439 | Celia Holmes | Registered Nurse | 505 S Main, Ste 249, Las Cruces, NM 88001 | 2016-09-01 |
| 1427420223 | Sara Guidetti | Family Medicine | 3080 Breland Drive, Las Cruces, NM 88001 | 2015-10-20 |
| 1679987234 | Maria De Jesus Martinez | Nurse Practitioner | 1170 N. Solano Ste A, Las Cruces, NM 88001 | 2014-06-11 |
| 1851701494 | Viola E Garcia | Case Manager/Care Coordinator | 100 W Griggs, Las Cruces, NM 88001 | 2014-05-05 |
| Find all providers in zip 88001 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891064150 | Randolph Philip Rountree | Psychologist | 1505 S Don Roser Dr Ste A, Las Cruces, NM 88011-4596 | 2011-12-15 |
| 1871780726 | Richard Nicastro | Psychologist | 1180 Commerce Dr, Las Cruces, NM 88011-8210 | 2007-09-25 |
| 1992928469 | Charles William Blanchard | Psychologist | 3205 Arrowhead Rd, Las Cruces, NM 88011-4786 | 2007-04-11 |
| 1194870303 | Southern New Mexico Psychological Associates Pa | Psychologist | 1655 Don Roser Dr, Las Cruces, NM 88011 | 2007-01-25 |
| 1316013915 | Isobel P Klein Hernandez | Psychologist | 427 N Reymond, Las Cruces, NM 88005 | 2006-11-27 |
| 1609950104 | Donna Jean Small | Psychologist | 2801 E Missouri Ave, #11, Las Cruces, NM 88011-5061 | 2006-10-24 |
| 1801978887 | Stuart S Kelter | Psychologist | 2145 El Paseo Rd, Las Cruces, NM 88001-6008 | 2006-10-19 |
| 1124113600 | Joe B Alexander | Psychologist | 4384 Sandalwood Dr, Las Cruces, NM 88011 | 2006-10-03 |
| 1477561173 | Howard B. Daniels | Psychologist | 1655 S Don Roser Dr, Las Cruces, NM 88011-4545 | 2006-08-04 |
| 1285661041 | David A Sachs | Psychologist | 3521 Del Rey Blvd, Las Cruces, NM 88012-7708 | 2006-06-27 |
| Find all providers in LAS CRUCES | ||||
| City | LAS CRUCES |
| Zip Code | 88001 |
Please comment or provide details below to improve the information on DR. MAX MASTELLONE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.