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Individual

ISAAC TREVINO JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
925 HESS TER, LAS CRUCES, NM 88005-2190
(575) 342-1317
Mailing address
12280 FORT MCLANE RD, LAS CRUCES, NM 88007-7121
(512) 921-1941

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
X-12360
NM
171M00000X
Case Manager/Care Coordinator
172V00000X
Community Health Worker

Other

Enumeration date
04/17/2019
Last updated
03/28/2022
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