Healthcare Provider Details

I. General information

NPI: 1518253111
Provider Name (Legal Business Name): KIMBERLY CHRISTINA LOMONACO HAYCRAFT PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2011
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BANNOCK ST
DENVER CO
80204-4597
US

IV. Provider business mailing address

777 BANNOCK ST
DENVER CO
80204-4597
US

V. Phone/Fax

Practice location:
  • Phone: 303-436-4200
  • Fax: 303-436-4448
Mailing address:
  • Phone: 303-436-4200
  • Fax: 303-436-4448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY.0003592
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.0998787-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: