Healthcare Provider Details

I. General information

NPI: 1578473963
Provider Name (Legal Business Name): JERICA BAEZA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9051 SSG CHRIS FALKEL DR UNIT 150
HIGHLANDS RANCH CO
80129-3191
US

IV. Provider business mailing address

4500 COPELAND CIR UNIT 203
HIGHLANDS RANCH CO
80126-7425
US

V. Phone/Fax

Practice location:
  • Phone: 720-213-4451
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL20302
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: