Provider Demographics
NPI:1841183290
Name:VALLEJOS, ERICA DENISE
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:DENISE
Last Name:VALLEJOS
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 1:720 N MAIN ST STE 330
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-3047
Mailing Address - Country:US
Mailing Address - Phone:719-569-7909
Mailing Address - Fax:719-569-7909
Practice Address - Street 1:720 N MAIN ST STE 330
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-3047
Practice Address - Country:US
Practice Address - Phone:719-569-7909
Practice Address - Fax:719-569-7909
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist