Individual
MR. JOSE DELFIN HERRERA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PCO
Contact information
Practice address
1115 N CALIFORNIA STREET, SOCORRO, NM 87801
(505) 838-0800
(505) 838-3999
Mailing address
701 COULSON DR, SOCORRO, NM 87801-4767
(505) 838-0800
(505) 838-3999
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1572
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
69676577
—
NM
05
—
88722520
—
NM
05
—
D4005
—
NM
Enumeration date
02/09/2007
Last updated
07/09/2007
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