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NPI Code Detail

MEDICARE: MRS. VICTORIA DE JESUS

MEDICARE: MRS. VICTORIA DE JESUS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1336573153
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. VICTORIA DE JESUS
Provider Business Mailing Address
First Line : 1955 ULSTER ST
Second Line : APT. 149
City : DENVER
State : CO
Zip : 80220-2065
Country : US
Telephone Number : 720-270-5709
Fax Number :
Provider Business Practice Location Address
First Line : 3101 W 14TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80204-2203
Country : US
Telephone Number : 720-270-5709
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2013
Last Update Date : 08/28/2013

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Directions to “ MRS. VICTORIA DE JESUS ” Practice Location

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