Healthcare Provider Details

I. General information

NPI: 1275028284
Provider Name (Legal Business Name): COLETTE QUATTRONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2018
Last Update Date: 06/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 ALPINE AVE
BOULDER CO
80304-3406
US

IV. Provider business mailing address

731 EXCELSIOR PL
LAFAYETTE CO
80026-2550
US

V. Phone/Fax

Practice location:
  • Phone: 303-443-8500
  • Fax:
Mailing address:
  • Phone: 303-818-9302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierK467198
Identifier TypeMEDICAID
Identifier StateCO
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: