Healthcare Provider Details

I. General information

NPI: 1568130599
Provider Name (Legal Business Name): TRISHA JEFFERS PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2021
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1259 LAKE PLAZA DR STE 255
COLORADO SPRINGS CO
80906-3542
US

IV. Provider business mailing address

1374 N FARLEY DR
PUEBLO WEST CO
81007-2320
US

V. Phone/Fax

Practice location:
  • Phone: 719-598-3585
  • Fax:
Mailing address:
  • Phone: 719-385-7237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY.0007066
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: