Organization
SANTA FE PSYCHOLOGICAL SERVICES LLC
Active
Organization
SANTA FE PSYCHOLOGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERNESTO FELIX SANTISTEVAN PH.D. (CLINICAL DIRECTOR)
(505) 577-2607
Entity
Organization
Contact information
Practice address
1807 2ND ST, SUITE 44, SANTA FE, NM 87505-3499
(505) 577-2607
(505) 982-1096
Mailing address
1000 CORDOVA PL, #548, SANTA FE, NM 87505-1725
(505) 577-2607
(505) 982-1096
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
688
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z0874
—
NM
Enumeration date
05/11/2007
Last updated
07/31/2015
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