Provider Demographics
NPI:1083066732
Name:PASTERKAMP, JANET
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:PASTERKAMP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4725 S LIPAN ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-6421
Mailing Address - Country:US
Mailing Address - Phone:303-761-5375
Mailing Address - Fax:
Practice Address - Street 1:4725 S LIPAN ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-6421
Practice Address - Country:US
Practice Address - Phone:303-761-5375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-06
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
385H00000X, 3747P1801X, 251S00000X
CO94-202-0785347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No347C00000XTransportation ServicesPrivate Vehicle
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No251S00000XAgenciesCommunity/Behavioral Health