Provider Demographics
NPI:1184312415
Name:SIRENA-PACHECO, AMAYA MARIA
Entity type:Individual
Prefix:
First Name:AMAYA
Middle Name:MARIA
Last Name:SIRENA-PACHECO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2628 NORMENT PL SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87105-7261
Mailing Address - Country:US
Mailing Address - Phone:505-730-3415
Mailing Address - Fax:
Practice Address - Street 1:2628 NORMENT PL SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87105-7261
Practice Address - Country:US
Practice Address - Phone:505-730-3415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician