Healthcare Provider Details

I. General information

NPI: 1497525505
Provider Name (Legal Business Name): JENNIFER VONEIDA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2024
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1832 WOODMOOR DR STE 210
MONUMENT CO
80132-9069
US

IV. Provider business mailing address

640 REMBRANDT CT
COLORADO SPRINGS CO
80921-2563
US

V. Phone/Fax

Practice location:
  • Phone: 719-428-5601
  • Fax:
Mailing address:
  • Phone: 719-428-5601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09931657
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: