Individual
LISA M CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPSW
Contact information
Practice address
12 UNSER BLVD SE STE C, RIO RANCHO, NM 87124-6300
(505) 636-6100
Mailing address
12 UNSER BLVD SE STE C, RIO RANCHO, NM 87124-6300
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
NONE
NM
175T00000X
Peer Specialist
Primary
1994
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55405509
—
NM
Enumeration date
02/09/2023
Last updated
02/13/2026
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