Provider Demographics
NPI:1912735689
Name:BERNTSEN, JOSHUA PETER
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:PETER
Last Name:BERNTSEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9185 W 45TH PL
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-3043
Mailing Address - Country:US
Mailing Address - Phone:719-651-0369
Mailing Address - Fax:
Practice Address - Street 1:9185 W 45TH PL
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-3043
Practice Address - Country:US
Practice Address - Phone:719-651-0369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator