DR. DIANA PORTILLO (NPI# 1194049841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194049841 |
| Entity Type | Individual |
| Full Name | DR. DIANA PORTILLO |
| Credential | DNP, FNP-C, PMHNP-BC |
| Practice Address |
330 N Campo St Las Cruces NM 88001-3433 |
| Mailing Address |
Po Box 1731 Las Cruces NM 88004-1731 |
| Practice Telephone | 5752881336 |
| Practice Fax Number | 5752224453 |
| Mailing Telephone | 5752881336 |
| Mailing Fax Number | 5752224453 |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2020-10-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
CNP-01613 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
CNP-01613 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 20636865 | 05 | |
| NM | MEDICARE | NMA100470 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 303 N Alameda Blvd, Las Cruces, NM 880052590 | 5755230111 | |
| 2701 W Picacho Ave Ste 4, Las Cruces, NM 880074732 | 5756523646 | 5756802415 |
| 850 N Motel Blvd, Las Cruces, NM 880078159 | 5755263437 | |
| 575 S Alameda Blvd, Las Cruces, NM 880052818 | 5755286400 | 5755217199 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629692470 | Diana Portillo | Registered Nurse | 19 Tacoma St, Worcester, MA 01605-3516 | 2020-06-07 |
| 1972147833 | Diana Portillo | Behavior Technician | 12432 Bellflower Blvd, Downey, CA 90242-2806 | 2019-11-04 |
| 1710367149 | Diana Aurora Portillo | Social Worker | 1 Hoyt St, 7th Floor, Brooklyn, NY 11201-5809 | 2015-06-01 |
| 1245575307 | Diana Portillo | Specialist/Technologist | 613 W Sesame Dr, Harlingen, TX 78550-7930 | 2012-11-30 |
| 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 |
| 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 |
| 1134278179 | Max Mastellone | Psychologist | 330 N Campo St, Las Cruces, NM 88001-3433 | 2007-01-09 |
| 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 | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588172290 | Cecilia Isolina Kasbohm | Nurse Practitioner | 999 W Amador Ave Ste A, Las Cruces, NM 88005-2739 | 2018-01-16 |
| 1831544618 | Clarion Telehealth Network, LLC | Nurse Practitioner | 4611 Research Park Cir Ste B227, Las Cruces, NM 88001-5948 | 2016-04-28 |
| 1639411051 | Lilian Agnete Klinger | Nurse Practitioner | 6932 Barcelona Ridge Rd, Las Cruces, NM 88007-8958 | 2013-03-24 |
| 1134459449 | Shelly Rae Noe | Nurse Practitioner | 1170 N Solano Dr Ste N, Las Cruces, NM 88001-2371 | 2010-01-08 |
| 1689868614 | Karen Marie Fee | Nurse Practitioner | 2144 Sagecrest Ave, Las Cruces, NM 88011-8045 | 2007-09-03 |
| 1396942074 | Jacquelyn Counts Williams | Nurse Practitioner | 3521 Del Rey Blvd Ste B, Las Cruces, NM 88012-7708 | 2007-06-27 |
| 1972714418 | Leslie Kaye Robbins | Nurse Practitioner | 3317 Solarridge St, Las Cruces, NM 88012-7797 | 2007-05-25 |
| 1316572373 | Ariel Hutton Madrid | Nurse Practitioner | 3751 Del Rey Blvd, Las Cruces, NM 88012-7710 | 2020-03-10 |
| 1063050151 | Deanna Joy Fresquez Mynatt | Nurse Practitioner | 1401 S Don Roser Dr, Las Cruces, NM 88011-4567 | 2019-12-19 |
| 1144767104 | Laura Smith | Nurse Practitioner | 250 S Main St, Las Cruces, NM 88001-1278 | 2017-01-27 |
| Find all providers in LAS CRUCES | ||||
| City | LAS CRUCES |
| Zip Code | 88001 |
Please comment or provide details below to improve the information on DR. DIANA PORTILLO.
| 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.