Healthcare Provider Details

I. General information

NPI: 1831531714
Provider Name (Legal Business Name): YVONNE NICOLE DELZENERO-MEHLBERG PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2013
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
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: 303-436-4949
  • Fax: 303-602-0050
Mailing address:
  • Phone: 303-436-4949
  • Fax: 303-602-0050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY.0004715
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: