Healthcare Provider Details

I. General information

NPI: 1831023779
Provider Name (Legal Business Name): JESSICA IRIS PEREA DN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 CHEYENNE BLVD STE 100
COLORADO SPRINGS CO
80905-2412
US

IV. Provider business mailing address

5 PINE RD
COLORADO SPRINGS CO
80906-4239
US

V. Phone/Fax

Practice location:
  • Phone: 719-301-7450
  • Fax:
Mailing address:
  • Phone: 719-774-7104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172P00000X
TaxonomyNaprapath
License NumberDN2026-0001
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: