Healthcare Provider Details

I. General information

NPI: 1184624520
Provider Name (Legal Business Name): JENNIFER S SIMONSON OD, FOVDR, FAAO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 VALMONT RD
BOULDER CO
80301-1310
US

IV. Provider business mailing address

1342 KANEMOTO LN
ERIE CO
80516-6946
US

V. Phone/Fax

Practice location:
  • Phone: 303-443-2257
  • Fax: 303-443-4599
Mailing address:
  • Phone: 720-281-5042
  • Fax: 303-443-4599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number2393
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: