Decrescentis, Tara Mendozza

Decrescentis, Tara Mendozza is an individual health care provider with primary practice located at 10099 Ridgegate Pkwy Ste 480 , Lone Tree CO 80124-5537. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Decrescentis, Tara Mendozza can be contacted via phone (720) 441-4021.

Contact Information

Primary practice address
10099 Ridgegate Pkwy Ste 480 Lone Tree CO 80124-5537
Phone: (720) 441-4021
Fax: (720) 360-1195
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2368 Colorado
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 2368 Colorado
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 2368 Colorado

Profile Details

NPI number 1407973266
LBN Legal business name Decrescentis, Tara Mendozza
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2007
Last updated Mar 17th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407973266 NPPES
Colorado Other 2368 LICENSE

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