Provider Demographics
NPI:1477702512
Name:PADILLA, FRANCES ANGELA (MACCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:FRANCES
Middle Name:ANGELA
Last Name:PADILLA
Suffix:
Gender:F
Credentials:MACCC-SLP
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 25685
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-0685
Mailing Address - Country:US
Mailing Address - Phone:505-720-0284
Mailing Address - Fax:505-836-3660
Practice Address - Street 1:6208 METEOR CT NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-4484
Practice Address - Country:US
Practice Address - Phone:505-720-0284
Practice Address - Fax:505-836-3660
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3792235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM98621823Medicaid