Healthcare Provider Details

I. General information

NPI: 1396669628
Provider Name (Legal Business Name): YAQUELIN VERGARA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5460 WARD RD STE 150
ARVADA CO
80002-1828
US

IV. Provider business mailing address

17910 E 54TH AVE
DENVER CO
80249-8815
US

V. Phone/Fax

Practice location:
  • Phone: 720-295-7548
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLSW.0009926391
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: