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SHASTIDY PAULINE LOPEZ CCSS
NPI 1962273854
Military Health Care Provider in Tijeras, NM

Active since January 10, 2024
1 CAMINO ORO CT, TIJERAS, NM 87059(706) 593-8731(706) 593-8732 Get Directions Write a Review

NPPES record last updated: September 26, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shastidy Pauline Lopez Ccss NPPES

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

SHASTIDY PAULINE LOPEZ CCSS (NPI 1962273854) is an individual military health care provider provider in Tijeras, New Mexico and active in the NPI registry since January 2024.

NPPES Registry Identity

NPI1962273854
Entity TypeIndividualFemale
Primary Taxonomy171000000X
Provider Legal NameSHASTIDY PAULINE LOPEZCredential: CCSS
Location Address1 CAMINO ORO CTTijeras, NM 87059-7924
Mailing AddressPo Box 45681Rio Rancho, NM 87174-5681 · (505) 226-1960 · Fax (505) 672-7769
Phone(706) 593-8731
Fax(706) 593-8732
Sole ProprietorNo
Enumeration DateJanuary 10, 2024
Last NPPES UpdateSeptember 26, 2024
NPPES CertifiedSeptember 26, 2024
✔ NPI 1962273854 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care ProviderOther Service Providers
Taxonomy Code171000000X
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
1 CAMINO ORO CT, Tijeras, NM 87059
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Other Names 1

Former Name (1)Shastidy Pauline Madrid

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID SEYEDSADR
Case Manager/Care Coordinator
1 CAMINO ORO CT
TIJERAS, NM 87059
Bernalillo County (505) 274-8534
ELLEN LORRAINE VAN DYKE CCSS
Case Manager/Care Coordinator
1 CAMINO ORO CT
TIJERAS, NM 87059
Bernalillo County (706) 593-8731
DAN GALLOVICH CPSW
Community Health Worker
1 CAMINO ORO CT
TIJERAS, NM 87059
Bernalillo County (505) 274-8534
ADRIAN GARCIA CHAVIRA CCSS
Case Manager/Care Coordinator
1 CAMINO ORO CT
TIJERAS, NM 87059
Bernalillo County (505) 274-8534
THERESA RAMIREZ
Case Manager/Care Coordinator
1 CAMINO ORO CT
TIJERAS, NM 87059
Bernalillo County (706) 593-8731
VALERIE R RODGERS
Case Manager/Care Coordinator
1 CAMINO ORO CT
TIJERAS, NM 87059
Bernalillo County (505) 274-8534
KRISTIN LYNNETTE COLLADO
Counselor (Mental Health)
1 CAMINO ORO CT
TIJERAS, NM 87059
Bernalillo County (505) 274-8534
NEW MEXICO TEEN CHALLENGE, INC.
Counselor (Addiction (Substance Use Disorder))
1 CAMINO ORO CT
TIJERAS, NM 87059
Bernalillo County (706) 596-8731

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 Shastidy Lopez's NPI number?

The NPI number for Shastidy Lopez is 1962273854. It was assigned to this individual provider in the NPPES registry on January 10, 2024. The provider is also known as Shastidy Pauline Madrid.

Where is Shastidy Lopez located?

Shastidy Lopez practices at 1 Camino Oro Ct, Tijeras, NM 87059. The listed phone number is (706) 593-8731.

What is Shastidy Lopez's specialty?

The primary specialty registered for this NPI is Military Health Care Provider with taxonomy code 171000000X.

When was this NPI record last updated?

The NPPES record for Shastidy Lopez was last updated on September 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.