SANDIA VISTA PSYCHIATRIC-MENTAL HEALTH
NPI 1396464723
Nurse Practitioner - Psychiatric/Mental Health in Albuquerque, NM

Q: What is Sandia Vista Psychiatric-Mental Health's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since August 29, 2022

9384 VALLEY VIEW DR NW STE 400, ALBUQUERQUE, NM 87114(505) 225-3110(505) 207-7988 Get Directions Write a Review

NPPES record last updated: November 18, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 18, 2025, Nov 9, 2023, Oct 31, 2023 and 2 more (5 updates tracked since 2022).

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About Sandia Vista Psychiatric-mental Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SANDIA VISTA PSYCHIATRIC-MENTAL HEALTH (NPI 1396464723) is a healthcare organization registered as a psychiatric/mental health in Albuquerque, New Mexico and active in the NPI registry since August 2022. The organization lists Desiree R Provencio, Member/manager, as its authorized official.

NPPES Registry Identity

NPI1396464723

Entity TypeOrganization

Primary Taxonomy363LP0808X

Legal Business NameSANDIA VISTA PSYCHIATRIC-MENTAL HEALTH

Location Address9384 VALLEY VIEW DR NW STE 400Albuquerque, NM 87114-4403

Mailing AddressPo Box 45450Rio Rancho, NM 87174-5450 · (505) 225-3110 · Fax (505) 207-7988

Phone(505) 225-3110

Fax(505) 207-7988

Organization SubpartNo

Authorized OfficialDesiree R ProvencioMember/manager · (505) 225-3110

Enumeration DateAugust 29, 2022

Last NPPES UpdateNovember 18, 20255 updates tracked since enumeration

NPPES CertifiedNovember 18, 2025

✔ NPI 1396464723 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

9384 VALLEY VIEW DR NW STE 400, Albuquerque, NM 87114

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sandia Vista Psychiatric-mental Health is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Sandia Vista Psychiatric-Mental Health, which bills Medicare for the services this clinician delivers.

Clinician (1)

Desiree Provencio, DNP, CNP, PMHNP-BC

Nurse Practitioner

NPI 1336648328

9384 VALLEY VIEW DR NW STE 400
Albuquerque, NM 87114

(505) 225-3110

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sandia Vista Psychiatric-Mental Health's NPI number?

The NPI number for Sandia Vista Psychiatric-Mental Health is 1396464723. It was assigned to this organization in the NPPES registry on August 29, 2022.

Where is Sandia Vista Psychiatric-Mental Health located?

Sandia Vista Psychiatric-Mental Health is located at 9384 Valley View Dr NW Ste 400, Albuquerque, NM 87114. The listed phone number is (505) 225-3110.

What is Sandia Vista Psychiatric-Mental Health's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Sandia Vista Psychiatric-Mental Health enrolled in Medicare?

Yes. Sandia Vista Psychiatric-Mental Health is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Sandia Vista Psychiatric-Mental Health?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Sandia Vista Psychiatric-Mental Health. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Sandia Vista Psychiatric-Mental Health was last updated on November 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.