Individual
JUAN ANTONIO SILVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCSS, CPSW
Contact information
Practice address
1215 4TH ST NW, ALBUQUERQUE, NM 87102-1414
(505) 589-0808
Mailing address
1215 4TH ST NW, ALBUQUERQUE, NM 87102-1414
(505) 389-5458
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NM
175T00000X
Peer Specialist
—
NM
Other
Enumeration date
06/17/2026
Last updated
06/17/2026
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