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General NPI Number Information
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NPI Number | 1750054011
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Entity Type | Individual
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Provider Name | JESSICA PACENZA
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Gender | Female
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Dates
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Enumeration Date | 07/31/2021
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Last Update Date | 07/31/2021
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Provider Practice Location Address
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Address Line | 8101 E MISSISSIPPI AVE
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City | DENVER
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State | CO
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Zip | 80247-1104
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Country | US
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Telephone | 303-249-7455
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Fax |
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Provider Business Mailing Address
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Address Line | 8013 S JACKSON ST
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City | CENTENNIAL
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State | CO
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Zip | 80122-3626
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Country | US
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Telephone | 303-249-7455
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 0001429
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License Number State | CO
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