Healthcare Provider Details

I. General information

NPI: 1508497348
Provider Name (Legal Business Name): JOSMAR TREJO-SANCHEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2020
Last Update Date: 01/30/2020
Certification Date: 01/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 W 26TH AVE STE 217C
DENVER CO
80211-5312
US

IV. Provider business mailing address

2460 W 26TH AVE STE 217C
DENVER CO
80211-5312
US

V. Phone/Fax

Practice location:
  • Phone: 303-322-7108
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: