Provider Demographics
NPI:1942079348
Name:JOJOLA, TRISTEN
Entity Type:Individual
Prefix:
First Name:TRISTEN
Middle Name:
Last Name:JOJOLA
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 1:85 HARTEL PL
Mailing Address - Street 2:
Mailing Address - City:RIO COMMUNITIES
Mailing Address - State:NM
Mailing Address - Zip Code:87002-7215
Mailing Address - Country:US
Mailing Address - Phone:575-517-9923
Mailing Address - Fax:
Practice Address - Street 1:85 HARTEL PL
Practice Address - Street 2:
Practice Address - City:RIO COMMUNITIES
Practice Address - State:NM
Practice Address - Zip Code:87002-7215
Practice Address - Country:US
Practice Address - Phone:575-517-9923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator