| Pueblo Pioneer Psychology | |
|
1124 Eagleridge Blvd Pueblo CO 81008-2103 | |
| (719) 470-0514 | |
| (719) 960-2444 |
| Full Name | Pueblo Pioneer Psychology |
|---|---|
| Speciality | Psychologist |
| Location | 1124 Eagleridge Blvd, Pueblo, Colorado |
| Authorized Official Name and Position | Arlyn Alzate (OFFICE MANAGER) |
| Authorized Official Contact | 7194700540 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pueblo Pioneer Psychology 1124 Eagleridge Blvd Pueblo CO 81008-2103 Ph: (719) 470-0514 | Pueblo Pioneer Psychology 1124 Eagleridge Blvd Pueblo CO 81008-2103 Ph: (719) 470-0514 |
| NPI Number | 1538689195 |
|---|---|
| Provider Enumeration Date | 06/26/2017 |
| Last Update Date | 04/12/2023 |
| Certification Date | 04/12/2023 |
| Medicare PECOS PAC ID | 3678848207 |
|---|---|
| Medicare Enrollment ID | O20171009001302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538689195 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Maria Emil Jimenez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295974426 PECOS PAC ID: 0840565479 Enrollment ID: I20171012000642 |
| Provider Name | Alfonso Cappa-melendez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649409715 PECOS PAC ID: 1759656382 Enrollment ID: I20171012003242 |
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