Provider Demographics
NPI:1023903317
Name:GABALDON, REBECCA ANDREA (CNP)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:ANDREA
Last Name:GABALDON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ANDREA
Other - Last Name:CORDOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:85 SQUARE DEAL RD
Mailing Address - Street 2:
Mailing Address - City:BELEN
Mailing Address - State:NM
Mailing Address - Zip Code:87002-6371
Mailing Address - Country:US
Mailing Address - Phone:505-903-1301
Mailing Address - Fax:
Practice Address - Street 1:2211 LOMAS BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2719
Practice Address - Country:US
Practice Address - Phone:505-272-1894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM82427208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics