MEDICARE: LA COCINA

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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1346097664
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LA COCINA

Provider Business Mailing Address
First Line	:	116 E OAK ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-2825
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3701 E MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80205-4974
Country	:	US
Telephone Number	:	720-618-4833
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	ANNA GOMEZ
Credential	:	LCSW
Telephone Number	:	970-818-8914

Provider Enumeration Date	:	05/03/2024
Last Update Date	:	03/13/2026

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Directions to “LA COCINA ” Practice Location

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