Healthcare Provider Details

I. General information

NPI: 1629635198
Provider Name (Legal Business Name): LILIANA TENA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2019
Last Update Date: 11/30/2022
Certification Date: 11/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4704 HARLAN ST
DENVER CO
80212-7415
US

IV. Provider business mailing address

4915 SHOSHONE ST
DENVER CO
80221-1323
US

V. Phone/Fax

Practice location:
  • Phone: 720-310-2773
  • Fax:
Mailing address:
  • Phone: 720-252-6635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: