JORGE LICANO (NPI# 1629679808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629679808 |
| Entity Type | Individual |
| Full Name | JORGE LICANO |
| Practice Address |
Unmh Hospital 2211 Lomas Blvd Ne Albuquerque NM 87106 |
| Mailing Address |
4536 Dearborn Hills Dr Ne Rio Rancho NM 87144-8696 |
| Practice Telephone | 5052723414 |
| Mailing Telephone | 5056049119 |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2020-11-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Unmh Hospital: 2211 Lomas Blvd Ne, -, Albuquerque, NM 871062719 | 5052723414 |
| Street Address |
UNMH HOSPITAL 2211 LOMAS BLVD NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730780032 | Joseph Sanchez | Student in an Organized Health Care Education/Training Program | (unmh Hospital 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2020-11-03 |
| 1336746205 | Evan Laub | Pharmacist | 2950 Central Ave. Sw, Albuquerque, NM 87106 | 2020-10-05 |
| 1487203154 | Theresa Martinez | Technician | 5680 Avedon Dr. Se, Albuquerque, NM 87106 | 2019-09-05 |
| 1205300647 | Louis Mayer II | Specialist/Technologist | 1414 University Blvd Tow Diehm Athletic Facility, Albuquerque, NM 87106 | 2019-01-18 |
| 1235633355 | Terrena Grace Vigil Brady | Occupational Therapist | 1001 Yale Blvd, Albuquerque, NM 87106 | 2018-03-22 |
| 1205355195 | Yaritza Ruiz | Specialist/Technologist | 1200 Avenida Cesar Chavez, 231d, Albuquerque, NM 87106 | 2017-09-12 |
| 1457873382 | Cynthia Bluhm | Registered Nurse | 7600 Cedar St Se Ste 7600, Albuquerque, NM 87106 | 2017-07-12 |
| 1295265882 | Hallie Chancellor | Behavior Technician | 1801 Gibson Blvd Se Apt 1046, Albuquerque, NM 87106 | 2017-06-15 |
| 1780111757 | Jiana Hook | Physical Medicine & Rehabilitation | 1414 University Blvd. Se, Albuquerque, NM 87106 | 2017-05-22 |
| 1245774983 | Joanna Dela Cruz Rossman | Anesthesiologist Assistant | 2211 Lomas Blvd Ne # Acm200, Albuquerque, NM 87106 | 2016-12-15 |
| Find all providers in zip 87106 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457952228 | Toshiyuki Shiina | Student in an Organized Health Care Education/Training Program | Unmh Hospital, 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2020-11-06 |
| 1730780032 | Joseph Sanchez | Student in an Organized Health Care Education/Training Program | (unmh Hospital 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2020-11-03 |
| 1447869144 | Tarab Mansoor | Student in an Organized Health Care Education/Training Program | Msc10 5620 1 University of New Mexico Albuquerque Nm, Albuquerque, NM 87131-0001 | 2020-07-28 |
| 1306454392 | Yusra Azhar | Student in an Organized Health Care Education/Training Program | Msc 5615 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2020-07-16 |
| 1154949360 | Muhammad Abdur Raafey | Student in an Organized Health Care Education/Training Program | Msc11 6025 University of New Mexico, Albuquerque, NM 87131-0001 | 2020-07-14 |
| 1194347344 | Waseem Zechariah Wagrees | Student in an Organized Health Care Education/Training Program | Department of Neurology Msc 105620, University of New Mexico, Albuquerque, NM 87131-0001 | 2020-05-11 |
| 1508487562 | Jonathan G Swope | Student in an Organized Health Care Education/Training Program | Msc (aegd) 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2020-04-30 |
| 1619598844 | Syed Faraz Faraz Kazim | Student in an Organized Health Care Education/Training Program | Department of Neurosurgery, Msc 10-5615, University of New Mexico School of Medicine, Albuquerque, NM 87131-0001 | 2020-04-28 |
| 1700407939 | Ravi Soni | Student in an Organized Health Care Education/Training Program | Department of Neurology 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2020-04-28 |
| 1548881824 | Bret Jarret Gardner | Student in an Organized Health Care Education/Training Program | Msc Department of Pediatrics 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2020-04-28 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87106 |
Please comment or provide details below to improve the information on JORGE LICANO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.