MR. JESSE LEE BACA (NPI# 1972151728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972151728 |
| Entity Type | Individual |
| Full Name | MR. JESSE LEE BACA |
| Credential | LSAA |
| Practice Address |
1235 8th St Las Vegas NM 87701-4219 |
| Mailing Address |
Po Box 158 Espanola NM 87532-0158 |
| Practice Telephone | 5054256788 |
| Mailing Telephone | 5057537218 |
| Mailing Fax Number | 5054263492 |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2019-08-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CSA0205961 | NM | Behavioral Health & Social Service Providers |
| Street Address |
1235 8TH ST |
| City | LAS VEGAS |
| State | NM |
| Zip Code | 87701-4219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861497901 | Yvonne D Vanarsdale-imani | Family Medicine | 1235 8th St, Las Vegas, NM 87701-4219 | 2005-06-16 |
| 1376157024 | Rose Marie Mcdonald | Nurse Practitioner | 1235 8th St, Las Vegas, NM 87701-4219 | 2020-09-01 |
| 1770195380 | Kelli Moore | Social Worker | 1235 8th St, Las Vegas, NM 87701-4219 | 2020-08-17 |
| 1427683549 | Francisca Cordova | Social Worker | 1235 8th St, Las Vegas, NM 87701-4219 | 2020-03-09 |
| 1821628306 | Jessica Turner | Social Worker | 1235 8th St, Las Vegas, NM 87701-4219 | 2020-01-23 |
| 1679122600 | Alba Melissa Weaver | Dentist | 1235 8th St, Las Vegas, NM 87701-4219 | 2019-09-11 |
| 1295217818 | Laura Robinson | Family Medicine | 1235 8th St, Las Vegas, NM 87701-4219 | 2018-08-30 |
| 1972090629 | Nona A Collins | Social Worker | 1235 8th St, Las Vegas, NM 87701-4219 | 2018-04-18 |
| 1679929186 | Danyelle Romero | Nurse Practitioner | 1235 8th St, Las Vegas, NM 87701-4219 | 2016-05-13 |
| 1659752228 | Chelsea Renee Lucero | Counselor | 1235 8th St, Las Vegas, NM 87701-4219 | 2015-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851884423 | Nueva Vida Counseling and Consulting Services LLC | Community/Behavioral Health | Nueva Vida Counseling & Consulting Services LLC, 1920 7th Street, Las Vegas, NM 87701 | 2018-06-08 |
| 1316475403 | El Centro Family Health | Family Medicine | 475 Legion Dr., Las Vegas, NM 87701 | 2017-06-01 |
| 1700327384 | Anastacia Sena Jaramillo | Psychologist | 126 Silva Ave., Las Vegas, NM 87701 | 2017-03-15 |
| 1013369222 | Home Medical Equipment Specialists,llc | Durable Medical Equipment & Medical Supplies | 514 8th Street, Las Vegas, NM 87701 | 2016-07-12 |
| 1750730826 | John Michael Tourangeau | Social Worker | 1920 7th Street, Las Vegas, NM 87701 | 2016-06-08 |
| 1154705689 | Lindsy Laura Kragt Allen | Podiatrist | 1608 7th St, Las Vegas, NM 87701 | 2015-07-14 |
| 1023409521 | Ambercare Medical Supply | Durable Medical Equipment & Medical Supplies | 1747 N Grand Ave, Las Vegas, NM 87701 | 2015-02-05 |
| 1538561964 | El Centro Family Health | Clinic/Center | 947 Old National Road, Las Vegas, NM 87701 | 2014-09-17 |
| 1164832150 | Plaza Drugs | Pharmacist | 178 Bridge St, Las Vegas, NM 87701 | 2014-04-30 |
| 1043648165 | Open Doors Home Health Care | Home Health | 713 Railroad Ave., Las Vegas, NM 87701 | 2013-10-29 |
| Find all providers in zip 87701 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
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| 1881200723 | Bauza Neuropsychiatry Center LLC | Counselor | 4268 Roanridge Ave, Las Vegas, NV 89120-2113 | 2020-09-16 |
| 1306451711 | Crest Healthcare Inc. | Counselor | 3275 S Jones Blvd Ste 106, Las Vegas, NV 89146-6768 | 2020-09-11 |
| 1043821671 | New Directions LLC | Counselor | 3651 S Lindell Dr, Ste D15 B, Las Vegas, NV 89103 | 2020-08-17 |
| 1831707975 | Jennifer Fluharty | Counselor | 8934 Candice Creek Ct, Las Vegas, NV 89149-3263 | 2020-07-15 |
| 1225666597 | Gwendolyn Mallory | Counselor | 4550 W Sahara Ave Apt 1241, Las Vegas, NV 89102-3648 | 2020-03-31 |
| 1134754120 | Shelley Denise Sargent | Counselor | 10593 Harvest Green Way, Las Vegas, NV 89135-1245 | 2020-03-10 |
| 1720610637 | Dsa Technoligies LLC | Counselor | 9504 City Hill Ct, Las Vegas, NV 89134-1711 | 2020-02-08 |
| 1811532781 | Melanie Fedraw | Counselor | 3661 S Maryland Pkwy Ste 64, Las Vegas, NV 89169-3005 | 2019-11-14 |
| 1457906729 | Elizabeth Ann Morris | Counselor | 7408 Mountain Thicket St, Las Vegas, NV 89131-4542 | 2019-08-05 |
| 1902450455 | Tracey Anora Henry | Counselor | 3675 Pecos Mecleod Ste 900, Las Vegas, NV 89121 | 2019-08-01 |
| Find all providers in LAS VEGAS | ||||
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| 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.