ANGEL FERNANDO CALLEROS (NPI# 1679173678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679173678 |
| Entity Type | Individual |
| Full Name | ANGEL FERNANDO CALLEROS |
| Practice Address |
203 California St Ne Albuquerque NM 87108-1802 |
| Mailing Address |
9500 Prospect Ave Ne Albuquerque NM 87112-2931 |
| Practice Telephone | 5053088296 |
| Mailing Telephone | 5052342511 |
| Enumeration Date | 2020-10-28 |
| Last Update Date | 2020-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | NEW MEXICO ID | 037438367 | 01 |
| Street Address |
203 CALIFORNIA ST NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87108-1802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871137042 | State of The Heart Recovery | Clinic/Center | 203 California St Ne, Albuquerque, NM 87108-1802 | 2019-10-31 |
| 1700407277 | State of The Heart Recovery Inc. | Clinic/Center | 203 California St Ne, Albuquerque, NM 87108-1802 | 2020-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588274393 | Aubrey Bunnenberg | Behavior Technician | 114 Pennsyvlania St. Ne Apt. 1, Albuquerque, NM 87108 | 2020-08-06 |
| 1336757301 | Dailey Doss | Physician Assistant | Raymond G. Murphy Va Medical Center, 1501 San Pedro Se, Albuquerque, NM 87108 | 2020-07-16 |
| 1457990046 | Christine Lovato | Registered Nurse | Albuquerque Treatment Services LLC, 123 Madeira Dr Se, Albuquerque, NM 87108 | 2019-12-30 |
| 1265074405 | Andrew Jacob Reuter | Pharmacist | 3816 Copper Ave Ne, Unit A, Albuquerque, NM 87108 | 2019-10-09 |
| 1518517325 | Lillian Abeyta | Technician | 1501 San Pedro Dr Se., Albuquerque, NM 87108 | 2019-09-13 |
| 1962970061 | Donald Borrego | Occupational Therapy Assistant | 5200 Copper Ne, #7, Albuquerque, NM 87108 | 2018-11-06 |
| 1154808012 | Catalina Castro | Social Worker | 209 San Pablo Se, Albuquerque, NM 87108 | 2018-07-24 |
| 1942721048 | Walgreen Co | Pharmacy | 933 San Mateo Blvd Ne Ste 501, Albuquerque, NM 87108 | 2017-06-29 |
| 1467981860 | Jennifer Martinez | Behavior Technician | 628 Espanola Se, Albuquerque, NM 87108 | 2017-06-08 |
| 1457892465 | J Dowd Counseling LLC | Counselor | 514 Monroe Street Se, Albuquerque, NM 87108 | 2017-03-10 |
| Find all providers in zip 87108 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053882795 | Mateo R Duran | Peer Specialist | 10519 Trieste Ct Nw, Albuquerque, NM 87114-5187 | 2018-12-06 |
| 1891174140 | Osman Varela | Peer Specialist | 402 1/2 Harvard Dr Se, Albuquerque, NM 87106-3527 | 2015-05-20 |
| 1407456742 | Gabriela Gallegos | Peer Specialist | 912 1st St Nw, Albuquerque, NM 87102-2355 | 2020-10-27 |
| 1306443148 | Andrea Michelle Vallejos | Peer Specialist | 805 Tijeras Ave Nw, Albuquerque, NM 87102-3099 | 2020-10-05 |
| 1033729652 | Stacy L Burleson | Peer Specialist | 3150 Carlisle Blvd Ne Ste 110, Albuquerque, NM 87110-1681 | 2020-08-07 |
| 1134738651 | Antonio N Johnson | Peer Specialist | 3301 Los Arboles Ave Ne, Albuquerque, NM 87107-1943 | 2020-07-30 |
| 1396363677 | Liliana Spurgeon | Peer Specialist | 9201 Montgomery Blvd Ne Bldg 5, Albuquerque, NM 87111-2468 | 2020-07-13 |
| 1801413026 | Christopher Padilla | Peer Specialist | 9201 Montgomery Blvd Ne Bldg 5, Albuquerque, NM 87111-2468 | 2020-07-03 |
| 1679196489 | Denise Lerouge | Peer Specialist | 9201 Montgomery Blvd Ne Bldg 5, Albuquerque, NM 87111-2468 | 2020-05-27 |
| 1942823125 | Dawn Green | Peer Specialist | 912 1st St Nw, Albuquerque, NM 87102-2355 | 2020-05-22 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87108 |
Please comment or provide details below to improve the information on ANGEL FERNANDO CALLEROS.
| 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.