Individual
JUSTIN SISNEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1031 LAMBERTON PL NE, ALBUQUERQUE, NM 87107-1641
(505) 272-2190
Mailing address
1031 LAMBERTON PL NE, ALBUQUERQUE, NM 87107-1641
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
Other
Enumeration date
08/03/2022
Last updated
10/18/2023
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