Healthcare Provider Details

I. General information

NPI: 1013232321
Provider Name (Legal Business Name): JODE MONIQUE VALLEJOS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2010
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 S POTOMAC ST
AURORA CO
80012-5405
US

IV. Provider business mailing address

7951 E MAPLEWOOD AVE STE 350
GREENWOOD VILLAGE CO
80111-4758
US

V. Phone/Fax

Practice location:
  • Phone: 303-418-7600
  • Fax: 303-750-3137
Mailing address:
  • Phone: 303-930-7895
  • Fax: 832-601-6018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3257
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0007140
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number4612
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: