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Individual

MRS. JULITA GLORIA PEZZANO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPCC

Contact information

Practice address
8625 GOLF COURSE RD NW STE B2, ALBUQUERQUE, NM 87114-5114
(505) 508-0808
(888) 896-8728
Mailing address
8625 GOLF COURSE RD NW, ALBUQUERQUE, NM 87114-5114
(505) 450-5500
(889) 896-8728

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
CCMH100131
NM
101YP2500X
Professional Counselor
Primary
CCMH0100131
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000413612
OPTUMBEHAVIORALHEALTH
NM
01
00NM00JBG7
BCBSNETWORK
NM
05
05959519
NM
01
11790874
CAQH
NM
01
3037108
UHCADVANTAGEPLANS
NM
01
600670199
MAGELLANHEALTHCARE
NM
Enumeration date
05/09/2007
Last updated
12/09/2025
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