Provider Demographics
NPI:1598434706
Name:LECHUGA, JOSE SAMUEL
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:SAMUEL
Last Name:LECHUGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2827 LINDA PL SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87105-4469
Mailing Address - Country:US
Mailing Address - Phone:505-435-3053
Mailing Address - Fax:
Practice Address - Street 1:640 ALCAZAR ST SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-1175
Practice Address - Country:US
Practice Address - Phone:505-435-3053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker