| Jennifer E Medina Phd Pc | |
|
3333 S Bannock St Ste 1010 Englewood CO 80110-2432 | |
| (720) 295-0357 | |
| Not Available |
| Full Name | Jennifer E Medina Phd Pc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 3333 S Bannock St Ste 1010, Englewood, Colorado |
| Authorized Official Name and Position | Jennifer Medina (OWNER) |
| Authorized Official Contact | 7733390621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer E Medina Phd Pc 3333 S Bannock St Ste 1010 Englewood CO 80110-2432 Ph: (720) 295-0357 | Jennifer E Medina Phd Pc 3333 S Bannock St Ste 1010 Englewood CO 80110-2432 Ph: (720) 295-0357 |
| NPI Number | 1649674524 |
|---|---|
| Provider Enumeration Date | 10/21/2014 |
| Last Update Date | 12/07/2015 |
| Medicare PECOS PAC ID | 5496078404 |
|---|---|
| Medicare Enrollment ID | O20150311002112 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649674524 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PSY.0004192 (Colorado) | Primary |
| Provider Name | Jennifer Elaine Medina |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144513821 PECOS PAC ID: 0143494658 Enrollment ID: I20150311002179 |
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