Provider Demographics
NPI:1174823579
Name:PACHECO, MARIAELENA
Entity Type:Individual
Prefix:MRS
First Name:MARIAELENA
Middle Name:
Last Name:PACHECO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8416 VISTA ESTRELLA LN SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87121-8969
Mailing Address - Country:US
Mailing Address - Phone:505-261-0776
Mailing Address - Fax:
Practice Address - Street 1:8416 VISTA ESTRELLA LN SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87121-8969
Practice Address - Country:US
Practice Address - Phone:505-261-0776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator