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NPI Code Detail

MEDICARE: LEO QUIJANO

MEDICARE: LEO QUIJANO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCO

General Provider Information

NPI Number : 1538016092
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEO QUIJANO
Provider Business Mailing Address
First Line : 4851 INDEPENDENCE ST FL 1
Second Line :
City : WHEAT RIDGE
State : CO
Zip : 80033-6715
Country : US
Telephone Number : 303-432-5115
Fax Number :
Provider Business Practice Location Address
First Line : 4851 INDEPENDENCE ST FL 1
Second Line :
City : WHEAT RIDGE
State : CO
Zip : 80033-6715
Country : US
Telephone Number : 303-432-5115
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2026
Last Update Date : 03/13/2026

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Directions to “ LEO QUIJANO ” Practice Location

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