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De Baca Family Practice Clinic

Federally Qualified Health Center (FQHC) in Santa Rosa, NM · enumerated 2013 · authorized official Lisa Walraven, Ceo.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1962743534

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Registry record

Entity type Organization (Type 2)
Legal business name De Baca Family Practice Clinic
Other name <Unavail>
Parent organization De Baca Family Practice Clinic
Practice address 552 Us Hwy 54, Santa Rosa, NM, 88435
Phone (575) 472-2414
Fax (575) 472-2416
Enumeration date Mar 7, 2013
Last updated in NPPES Feb 1, 2018

Taxonomy & classification

261QD0000X Dental Clinic/Center Ambulatory Health Care Facilities Secondary
261QF0400X Federally Qualified Health Center (FQHC) Ambulatory Health Care Facilities Primary

Authorized official

Name Lisa Walraven
Title Ceo
Phone (575) 355-2420

Other identifiers

Identifier Type State Issuer
84331534 Medicaid NM -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for De Baca Family Practice Clinic?
The NPI for De Baca Family Practice Clinic is 1962743534, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for De Baca Family Practice Clinic?
NPPES lists Lisa Walraven (Ceo) as the authorized official for this organization.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2018-02-01.