Provider Demographics
NPI:1376292151
Name:MAGANA LOPEZ, ALMA PAULINA
Entity Type:Individual
Prefix:
First Name:ALMA
Middle Name:PAULINA
Last Name:MAGANA LOPEZ
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:PO BOX 2523
Mailing Address - Street 2:
Mailing Address - City:SUNLAND PARK
Mailing Address - State:NM
Mailing Address - Zip Code:88063-2523
Mailing Address - Country:US
Mailing Address - Phone:575-915-1338
Mailing Address - Fax:575-915-1819
Practice Address - Street 1:5312 RIO BRAVO DR STE 10
Practice Address - Street 2:
Practice Address - City:SANTA TERESA
Practice Address - State:NM
Practice Address - Zip Code:88008-9210
Practice Address - Country:US
Practice Address - Phone:575-915-1338
Practice Address - Fax:575-915-1819
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No172V00000XOther Service ProvidersCommunity Health Worker