| Hidden Peaks Psychology, Pllc | |
|
3855 Ambrosia St Ste 302 Castle Rock CO 80109-3959 | |
| (720) 340-8290 | |
| Not Available |
| Full Name | Hidden Peaks Psychology, Pllc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 3855 Ambrosia St Ste 302, Castle Rock, Colorado |
| Authorized Official Name and Position | Fabian A Consbruck (NEUROPSYCHOLOGIST) |
| Authorized Official Contact | 7203408290 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hidden Peaks Psychology, Pllc 3855 Ambrosia St Ste 302 Castle Rock CO 80109-3959 Ph: (720) 340-8290 | Hidden Peaks Psychology, Pllc 3855 Ambrosia St Ste 302 Castle Rock CO 80109-3959 Ph: (720) 340-8290 |
| NPI Number | 1275260770 |
|---|---|
| Provider Enumeration Date | 08/04/2022 |
| Last Update Date | 08/04/2022 |
| Certification Date | 08/04/2022 |
| Medicare PECOS PAC ID | 0547643678 |
|---|---|
| Medicare Enrollment ID | O20220822003081 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275260770 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Fabian Alexandro Consbruck |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740764158 PECOS PAC ID: 5193158095 Enrollment ID: I20220822003377 |
| Provider Name | Kristopher Stewart Oldham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619357787 PECOS PAC ID: 7315250248 Enrollment ID: I20220916001218 |
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