Healthcare Provider Details

I. General information

NPI: 1851233290
Provider Name (Legal Business Name): KIANA MONIQUE PEREZ-JIMENEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6255 QUEBEC PKWY
COMMERCE CITY CO
80022-4812
US

IV. Provider business mailing address

237 GRAND LEGACY
NEW BRAUNFELS TX
78130-0642
US

V. Phone/Fax

Practice location:
  • Phone: 303-286-4235
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number00016079
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: