Provider Demographics
NPI:1407746050
Name:CHAVEZ, VISENTE
Entity type:Individual
Prefix:
First Name:VISENTE
Middle Name:
Last Name:CHAVEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1499 ZEPOL RD APT 201
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-7153
Mailing Address - Country:US
Mailing Address - Phone:405-436-9965
Mailing Address - Fax:
Practice Address - Street 1:1499 ZEPOL RD APT 201
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-7153
Practice Address - Country:US
Practice Address - Phone:405-436-9965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician