Healthcare Provider Details

I. General information

NPI: 1831099613
Provider Name (Legal Business Name): SIERRA QUINTANA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2026
Last Update Date: 11/06/2026
Certification Date: 11/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5495 ARAPAHOE AVE
BOULDER CO
80303-1260
US

IV. Provider business mailing address

2920 W 29TH AVE APT 108
DENVER CO
80211-4589
US

V. Phone/Fax

Practice location:
  • Phone: 720-848-9200
  • Fax:
Mailing address:
  • Phone: 208-861-4053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: