| La Clinica Tepeyac, Inc | |
|
5075 Lincoln Street Denver CO 80216-2015 | |
| (303) 458-5302 | |
| (303) 433-7452 |
| Full Name | La Clinica Tepeyac, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5075 Lincoln Street, Denver, Colorado |
| Authorized Official Name and Position | Jim Garcia (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3034585302 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| La Clinica Tepeyac, Inc 5075 Lincoln Street Denver CO 80216-2015 Ph: (303) 458-5302 | La Clinica Tepeyac, Inc 5075 Lincoln Street Denver CO 80216-2015 Ph: (303) 458-5302 |
| NPI Number | 1841526662 |
|---|---|
| Provider Enumeration Date | 10/29/2009 |
| Last Update Date | 11/03/2020 |
| Medicare PECOS PAC ID | 4082939962 |
|---|---|
| Medicare Enrollment ID | O20150218000141 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841526662 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Elizabeth Cookson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508866831 PECOS PAC ID: 3072598929 Enrollment ID: I20040623001034 |
| Provider Name | Rachel A Garza Haukoos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184928426 PECOS PAC ID: 1951574771 Enrollment ID: I20111024000067 |
| Provider Name | Christine Boughner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851834915 PECOS PAC ID: 3577840610 Enrollment ID: I20170427001808 |
| Provider Name | Ona Ahumada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790074763 PECOS PAC ID: 5496986523 Enrollment ID: I20170717001083 |
| Provider Name | Pamela L Valenza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760771083 PECOS PAC ID: 9032339858 Enrollment ID: I20180313001099 |
| Provider Name | Alison Catherine Quinn-beitscher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295043008 PECOS PAC ID: 3375776503 Enrollment ID: I20190314000139 |
| Provider Name | Daniel Robert Wells-prado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699237370 PECOS PAC ID: 4880936665 Enrollment ID: I20220919003139 |
| Provider Name | Patrick Huffer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871851766 PECOS PAC ID: 4486975083 Enrollment ID: I20221222002716 |
| Provider Name | Keely M Burke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043770290 PECOS PAC ID: 8426388224 Enrollment ID: I20230201000237 |
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