DR. RANDOLPH PHILIP BACA JR. (NPI# 1790982643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790982643 |
| Entity Type | Individual |
| Full Name | DR. RANDOLPH PHILIP BACA JR. |
| Credential | M.D. |
| Practice Address |
6666 4th St Nw Los Ranchos NM 87107-6144 |
| Mailing Address |
Po Box 95602 Albuquerque NM 87199-5602 |
| Practice Telephone | 5055045505 |
| Mailing Telephone | 5052009855 |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2015-11-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
AG3361893-B416 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 13558242 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558660555 | Randolph F Baca | Chiropractor | 8725 Wadsworth Blvd Ste A, Arvada, CO 80003-0922 | 2011-03-16 |
| Street Address |
6666 4TH ST NW |
| City | LOS RANCHOS |
| State | NM |
| Zip Code | 87107-6144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235107137 | Sylma Fine | Counselor | 6666 4th St Nw, Los Ranchos, NM 87107-6144 | 2006-03-08 |
| 1023643665 | Oscar Elias | Registered Nurse | 6666 4th St Nw, Los Ranchos, NM 87107-6144 | 2020-03-04 |
| 1871061549 | Alejandra Perea | Counselor | 6666 4th St Nw, Los Ranchos, NM 87107-6144 | 2018-11-11 |
| 1235586967 | A Guiding Path, LLC | Counselor | 6666 4th St Nw, Los Ranchos, NM 87107-6144 | 2016-05-23 |
| 1942548714 | Maya S Fernandez | Counselor | 6666 4th St Nw, Los Ranchos, NM 87107-6144 | 2013-01-29 |
| 1699013169 | Patricia Martinez Burr, Ma, Lpcc, Ncc | Counselor | 6666 4th St Nw, Suite B, Los Ranchos, NM 87107-6144 | 2013-01-17 |
| 1679825095 | Sylma Fine | Community/Behavioral Health | 6666 4th St Nw, Los Ranchos, NM 87107-6144 | 2012-10-09 |
| 1891056909 | Four Corners Mental and Behavioral Health PC | Counselor | 6666 4th St Nw, Los Ranchos, NM 87107-6144 | 2012-06-05 |
| 1912201161 | Kathleen Luellen Chabot | Counselor | 6666 4th St Nw, Suite D, Los Ranchos, NM 87107-6144 | 2011-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589785 | Benjamin Argant | Behavior Technician | 331 Candelaria Road North East Suite A, Albuquerque, NM 87107 | 2020-08-20 |
| 1679138861 | Susan Luna, Lpcc LLC | Counselor | 3221 B Candelaria Ne, Albuquerque, NM 87107 | 2019-05-03 |
| 1407310881 | Eleanor Cloe Tibbetts | Speech-Language Pathologist | 7103 4th St. Nw Chatterbox Speech Therapy, Los Ranchos, NM 87107 | 2019-01-30 |
| 1386174829 | Triple D Medical Transportation, LLC. | Secured Medical Transport (VAN) | 2123 Menaul Blvd Ne Ste B, Albuquerque, NM 87107 | 2017-06-18 |
| 1487100715 | Kayleen Weinandt | Community/Behavioral Health | 3301 Los Arboles Ne, Albuquerque, NM 87107 | 2016-08-28 |
| 1811345549 | Inverse Medical, LLC | Non-emergency Medical Transport (VAN) | 1015 Cottonwood Dr. Suite J, Albuquerque, NM 87107 | 2016-06-03 |
| 1710349220 | Evolv Strong, LLC | Specialist/Technologist | 3201 Candelaria Rd Ne, Albuquerque, NM 87107 | 2016-03-23 |
| 1982072443 | Erik Robinson | Social Worker | 7801 Academy Road, Ne 2-200, Albueruque, NM 87107 | 2015-09-14 |
| 1033505763 | Sam Newmon Ma, Lpcc | Counselor | 320-h Osuna Rd Ne, Suite 4, Albuquerque, NM 87107 | 2015-04-09 |
| 1760896203 | Jocelyn Fiaschetti | Social Worker | 7704 4th Street Nw, Albuquerque, NM 87107 | 2014-06-12 |
| Find all providers in zip 87107 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982219499 | Chrysalis Healthcare LLC | Psychiatry & Neurology | 2632 Mesilla St Ne Ste 6, Albuquerque, NM 87110-3614 | 2020-09-11 |
| 1386283943 | Luxe Psychiatric and Wellness Services LLC | Psychiatry & Neurology | 613 W 2nd St Ste 3, Roswell, NM 88201-4671 | 2019-12-31 |
| 1386283869 | New Age Behavioral Health, LLC | Psychiatry & Neurology | 3600 Rodeo Ln Ste 5, Santa Fe, NM 87507-6400 | 2019-12-31 |
| 1922646595 | Psychogenesis LLC | Psychiatry & Neurology | 3900 Eubank Blvd Ne Ste 18, Albuquerque, NM 87111-3427 | 2019-12-14 |
| 1255991428 | Robert Charles Larsen | Psychiatry & Neurology | 7 Paintbrush Cir, Santa Fe, NM 87506-9539 | 2019-06-19 |
| 1316391063 | North Star Psychiatric Services, LLC | Psychiatry & Neurology | 1475 Central Ave, Suite 210, Los Alamos, NM 87544-3160 | 2016-04-19 |
| 1063891307 | Lynnet M Bulambo | Psychiatry & Neurology | 613 W 2nd St # 1&3, Roswell, NM 88201-4671 | 2015-05-20 |
| 1134515737 | Amanda S Valone | Psychiatry & Neurology | 1501 San Pedro Dr Se Rm 145, Albuquerque, NM 87108-5180 | 2015-04-09 |
| 1932514288 | Christine M Clark | Psychiatry & Neurology | 1 University of New Mexico # 95030, Albuquerque, NM 87131-0001 | 2014-06-25 |
| 1790105369 | Monique Elise Ethne Simpson | Psychiatry & Neurology | 320 Gold Ave Sw Ste 1001, Albuquerque, NM 87102-3228 | 2014-04-22 |
| Find all providers with the same taxonomy | ||||
| City | LOS RANCHOS |
| Zip Code | 87107 |
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| 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.