JEAN VAN DE POLDER (NPI# 1073686762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073686762 |
| Entity Type | Individual |
| Full Name | JEAN VAN DE POLDER |
| Credential | M.D. |
| Practice Address |
1646 Elmira St Aurora CO 80010-2122 |
| Mailing Address |
11059 E Bethany Dr Suite 200 Aurora CO 80014-2622 |
| Practice Telephone | 3036172498 |
| Practice Fax Number | 3036172832 |
| Mailing Telephone | 3036172300 |
| Mailing Fax Number | 3036172397 |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2016-06-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
18268 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | DEA | AV5642524 | 01 |
| Street Address |
1646 ELMIRA ST |
| City | AURORA |
| State | CO |
| Zip Code | 80010-2122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487738423 | Mara Jean Kailin | Psychologist | 1646 Elmira St, Aurora, CO 80010-2122 | 2006-10-25 |
| 1538716808 | Mckenzie Frances Hill | Social Worker | 1646 Elmira St, Aurora, CO 80010-2122 | 2019-08-21 |
| 1417434242 | Heather T Leffew | Counselor | 1646 Elmira St, Aurora, CO 80010-2122 | 2018-07-24 |
| 1962927863 | Maegan Sullivan | Student in an Organized Health Care Education/Training Program | 1646 Elmira St, Aurora, CO 80010-2122 | 2017-08-11 |
| 1396279972 | Ernestine Garcia Luna | Case Manager/Care Coordinator | 1646 Elmira St, Aurora, CO 80010-2122 | 2017-04-20 |
| 1306210695 | Angie Medina | Counselor | 1646 Elmira St, Aurora, CO 80010-2122 | 2015-11-24 |
| 1548632326 | David Thang | Community Health Worker | 1646 Elmira St, Aurora, CO 80010-2122 | 2015-10-20 |
| 1114396462 | Lindsey Rushing | Counselor | 1646 Elmira St, Aurora, CO 80010-2122 | 2015-09-16 |
| 1770961070 | Henriette Habimana | Case Manager/Care Coordinator | 1646 Elmira St, Aurora, CO 80010-2122 | 2015-05-07 |
| 1285027789 | Suaad Amin | Student in an Organized Health Care Education/Training Program | 1646 Elmira St, Aurora, CO 80010-2122 | 2015-03-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255991659 | Jennifer Hummer Fisher | Registered Nurse | Dawn Clinic, 1445 Dayton St, Aurora, CO 80010 | 2019-06-18 |
| 1770147662 | Lindsey Grace Torres | Counselor | 1455 Beeler Str., Aurora, CO 80010 | 2019-04-25 |
| 1700359536 | Jose Alberto Diaz Leo | Registered Nurse | 9801 East Colfax, Suite 130, Aurora, CO 80010 | 2019-01-04 |
| 1235617440 | Jose Francisco Gurruchaga | Student in an Organized Health Care Education/Training Program | 1504 Galena St., Aurora, CO 80010 | 2018-07-31 |
| 1659727907 | Nauliate Hutagalung | Case Manager/Care Coordinator | 995 Kenton St, Aurora, CO 80010 | 2016-05-05 |
| 1144626888 | Diana Hinojosa | Psychologist | 10680 Del Mar Pkwy, Aurora, CO 80010 | 2014-11-06 |
| 1487059614 | Jyoti Sapkota | Counselor | 1537 Alton St., Aurora, CO 80010 | 2014-10-30 |
| 1972925543 | Sonam Khanal | Social Worker | 1537 Alton St, Aurora, Aurora, CO 80010 | 2014-01-15 |
| 1487925665 | Ardas LLC | Clinic/Center | 10180 E Colfax Ave Ste 150, Aurora, CO 80010 | 2012-01-20 |
| 1255666376 | Smile 5 Professionals LLC | Dentist | 10401 East Colfax Ave, Aurora, CO 80010 | 2009-10-07 |
| Find all providers in zip 80010 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023544277 | Paula Riggs | Psychiatry & Neurology | 12469 East 17th Place, Building 400, Aurora, CO 80045 | 2017-05-10 |
| 1750480398 | Katherine Lynn Keeton | Psychiatry & Neurology | 1291 S Potomac, Aurora, CO 80012 | 2006-09-21 |
| 1093245250 | Rebecca Iza Katz | Psychiatry & Neurology | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2017-06-19 |
| 1760914774 | Chloe L Yeung | Psychiatry & Neurology | 13123 E. 16th Avenue, Gary Pavilion 4th Floor, Aurora, CO 80045 | 2017-03-29 |
| 1578927273 | Jodi Zik | Psychiatry & Neurology | 13001 E 17th Pl, Aurora, CO 80045-2570 | 2016-04-08 |
| 1164819520 | Anastasia Klott | Psychiatry & Neurology | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2015-04-22 |
| 1598151508 | Jesse Hinckley | Psychiatry & Neurology | 13001 E 17th Pl, Aurora, CO 80045-2570 | 2015-04-07 |
| 1407241003 | Allison Nicole Hoff | Psychiatry & Neurology | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2015-03-31 |
| 1689092819 | Christopher Michael Piatz | Psychiatry & Neurology | 13001 E 17th Pl, Building 500 Mail Stop F546, Aurora, CO 80045-2570 | 2014-04-04 |
| 1386089134 | Eva Diaz | Psychiatry & Neurology | 13123 E 16th Ave, Aurora, CO 80045 | 2013-05-07 |
| Find all providers in AURORA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.