Organization · Type 2 NPI
Mayedel A San Jose PC
Family Nurse Practitioner · Santa Teresa, NM
NPI number
1083305510
Active
Practice location
5290 Mcnutt Rd Ste 103
Santa Teresa, NM 88008-9648
Fax (818) 337-1474
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Health Service Clinic/Center | 261QH0100X | None listed |
| Family Nurse Practitioner Primary | 363LF0000X | None listed |
Family Nurse Practitioner: Definition to come...
3 other providers at this address
About NPI 1083305510
Mayedel A San Jose PC's National Provider Identifier is 1083305510, issued on May 16, 2023. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Santa Teresa, NM. The record was last updated on Oct 18, 2026.