Individual
DR. ERNESTO SANTISTEVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4001 OFFICE COURT DR STE 1008, SANTA FE, NM 87507-4929
(505) 577-2607
(505) 982-1096
Mailing address
3201 ZAFARANO DR STE C, SANTA FE, NM 87507-2672
(505) 577-2607
(505) 982-1096
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
688
NM
103TP0016X
Prescribing (Medical) Psychologist
Primary
688
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z0874
—
NM
Enumeration date
05/23/2007
Last updated
03/18/2026
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