Provider Demographics
NPI:1790521557
Name:TAFOYA, YOLANDA (BCH, CCHW, CCSS)
Entity type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:
Last Name:TAFOYA
Suffix:
Gender:F
Credentials:BCH, CCHW, CCSS
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 42
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NM
Mailing Address - Zip Code:87936-0042
Mailing Address - Country:US
Mailing Address - Phone:575-644-4853
Mailing Address - Fax:
Practice Address - Street 1:808 FIR ST
Practice Address - Street 2:
Practice Address - City:TRUTH OR CONSEQUENCES
Practice Address - State:NM
Practice Address - Zip Code:87901-1724
Practice Address - Country:US
Practice Address - Phone:575-208-4045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM174H00000X
251B00000X
NMG-1380172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth Educator
No251B00000XAgenciesCase Management