Healthcare Provider Details

I. General information

NPI: 1619286317
Provider Name (Legal Business Name): MARIANA LUCCHESA NALDI PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2010
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 S COLORADO BLVD STE B-108
DENVER CO
80222-3303
US

IV. Provider business mailing address

1325 S COLORADO BLVD STE B-108
DENVER CO
80222-3303
US

V. Phone/Fax

Practice location:
  • Phone: 720-443-2712
  • Fax:
Mailing address:
  • Phone: 720-443-2712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY.0006260
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: