Autumn Years Pllc | |
9449 Yale Ln Highlands Ranch CO 80130-3726 | |
(970) 805-0716 | |
Not Available |
Full Name | Autumn Years Pllc |
---|---|
Speciality | Clinic/Center |
Location | 9449 Yale Ln, Highlands Ranch, Colorado |
Authorized Official Name and Position | Kristy Shoji (OWNER) |
Authorized Official Contact | 9708050716 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Autumn Years Pllc 9449 Yale Ln Highlands Ranch CO 80130-3726 Ph: (970) 805-0716 | Autumn Years Pllc 9449 Yale Ln Highlands Ranch CO 80130-3726 Ph: (970) 805-0716 |
NPI Number | 1770394777 |
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Provider Enumeration Date | 01/17/2025 |
Last Update Date | 01/17/2025 |
Medicare PECOS PAC ID | 7719416692 |
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Medicare Enrollment ID | O20250122000577 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770394777 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Kristy Shoji |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1770002891 PECOS PAC ID: 8628507506 Enrollment ID: I20250122000699 |
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