Individual
SANDRA LENGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1100 CENTRAL AVE SE, ALBUQUERQUE, NM 87106-4930
(505) 841-1737
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
508665563
NM
363A00000X
Physician Assistant
Primary
63291
CA
363A00000X
Physician Assistant
PA2021-0090
NM
Other
Enumeration date
07/01/2016
Last updated
12/13/2024
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