Healthcare Provider Details

I. General information

NPI: 1699586610
Provider Name (Legal Business Name): VIRIDIANA ROJO BURCIAGA LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2025
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 TELLURIDE ST UNIT 750
BRIGHTON CO
80601-4368
US

IV. Provider business mailing address

1742 WILDWOOD ST
LOCHBUIE CO
80603-5812
US

V. Phone/Fax

Practice location:
  • Phone: 303-588-0057
  • Fax:
Mailing address:
  • Phone: 303-588-0057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT.0023748
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: