MEDICARE: JESSICA BLOOMFIELD PLATO PSY.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
1	103T00000X	Psychologist	3659	NC
2	103TC0700X	Clinical Psychologist	4252	CO

General Provider Information

NPI Number	:	1477707727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA BLOOMFIELD PLATO PSY.D.

Provider Business Mailing Address
First Line	:	1315 S CLAYTON ST STE 300
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-2456
Country	:	US
Telephone Number	:	720-460-0543
Fax Number	:	704-552-7550

Provider Business Practice Location Address
First Line	:	1315 S CLAYTON ST STE 300
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-2456
Country	:	US
Telephone Number	:	720-460-0543
Fax Number	:	704-552-7550

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2008
Last Update Date	:	03/10/2025

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