Provider Demographics
NPI:1508525486
Name:VOLCANO VISTA PSYCHIATRY & WELLNESS LLC
Entity Type:Organization
Organization Name:VOLCANO VISTA PSYCHIATRY & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:VERZI
Authorized Official - Suffix:
Authorized Official - Credentials:CNP, DNP, PMHNP-BC
Authorized Official - Phone:505-404-9364
Mailing Address - Street 1:PO BOX 561
Mailing Address - Street 2:
Mailing Address - City:PLACITAS
Mailing Address - State:NM
Mailing Address - Zip Code:87043-0561
Mailing Address - Country:US
Mailing Address - Phone:505-404-9364
Mailing Address - Fax:
Practice Address - Street 1:140 JUNIPER RD
Practice Address - Street 2:
Practice Address - City:PLACITAS
Practice Address - State:NM
Practice Address - Zip Code:87043-9123
Practice Address - Country:US
Practice Address - Phone:505-404-9364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty