Provider Demographics
NPI:1194445528
Name:HIGH DESERT PSYCHIATRY LLC
Entity type:Organization
Organization Name:HIGH DESERT PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:MS
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CRESPIN
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, CNP, PMHNP-BC
Authorized Official - Phone:505-917-6932
Mailing Address - Street 1:6300 RIVERSIDE PLAZA LN NW STE 100
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-1908
Mailing Address - Country:US
Mailing Address - Phone:505-917-6932
Mailing Address - Fax:
Practice Address - Street 1:6300 RIVERSIDE PLAZA LN NW STE 100
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-1908
Practice Address - Country:US
Practice Address - Phone:505-917-6932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2023-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty