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General NPI Number Information
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NPI Number | 1205623329
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Entity Type | Individual
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Provider Name | EFREN MARTIN TEJADA JR.
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Gender |
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 1905 N SHERMAN ST STE 1008
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City | DENVER
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State | CO
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Zip | 80203-1130
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Country | US
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Telephone | 720-915-5550
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Fax |
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Provider Business Mailing Address
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Address Line | 9595 PECOS ST LOT 30
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City | THORNTON
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State | CO
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Zip | 80260-5927
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Country | US
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Telephone | 805-397-9650
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | BACB920458
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License Number State | CO
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