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NPI Code Detail

MEDICARE: DR. JOHN JEROME KREGARMAN PH.D.

MEDICARE: DR. JOHN JEROME KREGARMAN PH.D.
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
1103TC0700XClinical Psychologist187CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346246956
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN JEROME KREGARMAN PH.D.
Provider Business Mailing Address
First Line : 754 S ONEIDA WAY
Second Line :
City : DENVER
State : CO
Zip : 80224-1567
Country : US
Telephone Number : 303-393-1701
Fax Number : 503-210-7112
Provider Business Practice Location Address
First Line : 9745 E HAMPDEN AVE
Second Line : STE 240
City : DENVER
State : CO
Zip : 80231-4922
Country : US
Telephone Number : 303-752-7159
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 07/08/2007

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