Healthcare Provider Details

I. General information

NPI: 1447035118
Provider Name (Legal Business Name): JOSHUA E BOCK PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2023
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 S COLLEGE AVE STE 207
FORT COLLINS CO
80525-1484
US

IV. Provider business mailing address

2000 S COLLEGE AVE STE 207
FORT COLLINS CO
80525-1484
US

V. Phone/Fax

Practice location:
  • Phone: 970-638-5537
  • Fax:
Mailing address:
  • Phone: 970-638-5537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSYC.00015484
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: