Healthcare Provider Details

I. General information

NPI: 1023684057
Provider Name (Legal Business Name): BAHROZE RAKEEN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 02/16/2025
Certification Date: 02/16/2025
Deactivation Date: 02/04/2023
Reactivation Date: 08/25/2023

III. Provider practice location address

3055 ROSLYN ST UNIT 100
DENVER CO
80238-3324
US

IV. Provider business mailing address

3055 ROSLYN ST UNIT 100
DENVER CO
80238-3324
US

V. Phone/Fax

Practice location:
  • Phone: 720-848-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number0006685
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: