Provider Demographics
NPI:1588332217
Name:ARANDA, JOSEPH MARTIN
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:MARTIN
Last Name:ARANDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4013 FLORA VISTA AVE SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87121-5167
Mailing Address - Country:US
Mailing Address - Phone:505-977-8546
Mailing Address - Fax:
Practice Address - Street 1:4013 FLORA VISTA AVE SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87121-5167
Practice Address - Country:US
Practice Address - Phone:505-977-8546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM501042927Medicaid