Healthcare Provider Details

I. General information

NPI: 1669353231
Provider Name (Legal Business Name): ALISHA RANAE MENDOZA PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 MADISON ST STE 704
DENVER CO
80206-5416
US

IV. Provider business mailing address

5438 E 144TH PL
THORNTON CO
80602-8382
US

V. Phone/Fax

Practice location:
  • Phone: 623-233-0914
  • Fax: 623-321-6050
Mailing address:
  • Phone: 720-668-4902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberAPN.1001159-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: