Healthcare Provider Details

I. General information

NPI: 1043513617
Provider Name (Legal Business Name): JUDY POMERANTZ, PSY.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2010
Last Update Date: 12/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 E MISSISSIPPI AVE SUITE 600
GLENDALE CO
80246-3048
US

IV. Provider business mailing address

4100 E MISSISSIPPI AVE SUITE 600
GLENDALE CO
80246-3048
US

V. Phone/Fax

Practice location:
  • Phone: 303-759-3098
  • Fax: 303-759-3515
Mailing address:
  • Phone: 303-759-3098
  • Fax: 303-759-3515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2046
License Number StateCO

VIII. Authorized Official

Name: DR. JUDY POMERANTZ
Title or Position: PRESIDENT
Credential: PSY.D.
Phone: 303-759-3098