Healthcare Provider Details

I. General information

NPI: 1598686354
Provider Name (Legal Business Name): JEANETTE FLOREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6224 ROOKERY RD
FORT COLLINS CO
80528-9476
US

IV. Provider business mailing address

6224 ROOKERY RD
FORT COLLINS CO
80528-9476
US

V. Phone/Fax

Practice location:
  • Phone: 970-690-0724
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: