JOSEPH YERETSIAN, P.C. (NPI# 1942668165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942668165 |
| Entity Type | Organization |
| Organization Name | JOSEPH YERETSIAN, P.C. |
| Other Organization Name | OPTIMINDHEALTH |
| Practice Address |
4770 Baseline Rd Ste 200 Boulder CO 80303-2668 |
| Mailing Address |
4770 Baseline Rd 2nd Floor Boulder CO 80303-2666 |
| Practice Telephone | 7208930842 |
| Mailing Telephone | 7208930842 |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2020-01-02 |
| Authorized Official Name | DR. JOSEPH YERETSIAN (PRESIDENT) |
| Authorized Official Telephone | 6175071472 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
DR.0056212 | CO | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| OptiMindHealth | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | JOSEPH YERETSIAN, P.C. | 4770 Baseline Road, Suite 200, Boulder, CO 80303 |
| Street Address |
4770 BASELINE RD STE 200 |
| City | BOULDER |
| State | CO |
| Zip Code | 80303-2668 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457539603 | Heather L. Steffen | Psychologist | 4770 Baseline Rd Ste 200, Boulder, CO 80303-2668 | 2008-02-08 |
| 1871123356 | Alexis Larocca | Behavior Technician | 4770 Baseline Rd Ste 200, Boulder, CO 80303-2668 | 2020-01-23 |
| 1336779172 | Emily Prange | Behavior Technician | 4770 Baseline Rd Ste 200, Boulder, CO 80303-2668 | 2020-01-21 |
| 1528698339 | Mikio Minobe | Behavior Technician | 4770 Baseline Rd Ste 200, Boulder, CO 80303-2668 | 2020-01-21 |
| 1871139337 | Antonio Stone | Nurse Practitioner | 4770 Baseline Rd Ste 200, Boulder, CO 80303-2668 | 2019-11-20 |
| 1336687060 | Sarah Schumacher | Registered Nurse | 4770 Baseline Rd Ste 200, Boulder, CO 80303-2668 | 2017-02-01 |
| 1154715894 | Marnessa J Bambara | Social Worker | 4770 Baseline Rd Ste 200, Boulder, CO 80303-2668 | 2015-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821583725 | Ariel Meyers | Physical Therapist | Frasier Meadows Retirement Community Dept. of Rehab, 350 Ponca Place, Boulder, CO 80303 | 2018-06-25 |
| 1831683838 | Sandra Ramsey | Occupational Therapist | 350 Ponca, Boulder, CO 80303 | 2018-06-22 |
| 1770085243 | Laura Michelle Boucher | Physical Medicine & Rehabilitation | 5387 Manhattan Cir, Ste 200, Boulder, CO 80303 | 2018-03-01 |
| 1396255568 | Colorado Sports Chiropractic | Chiropractor | 1440 28th St Ste 2, Boulder, CO 80303 | 2017-10-02 |
| 1932618782 | Michele Adrienne Packard | Psychologist | 4410 Arapahoe Suite 140, Boulder, CO 80303 | 2017-09-25 |
| 1134505290 | Bili Blanket Baby, LLC | Durable Medical Equipment & Medical Supplies | 4450 Arapahoe Ave, Suite 100, Boulder, CO 80303 | 2015-07-30 |
| 1710378146 | Jonathan Gardiner Lears | Counselor | 5600 Arapahoe Ave, Suite 102, Boulder, CO 80303 | 2015-02-06 |
| 1114316965 | Northstar Transitions | Substance Abuse Rehabilitation Facility | 75 Manhattan Dr., Suites 110 and 208 Northstar Transitions, Boulder, CO 80303 | 2015-01-16 |
| 1902226434 | Integrated Dermatology of Boulder, Pllc | Dermatology | 2935 Baseline Road, Suite 201, Boulder, CO 80303 | 2014-04-23 |
| 1396160081 | Melissa Rupert | Physical Therapist | 975 Waite Drive, Boulder, CO 80303 | 2014-03-04 |
| Find all providers in zip 80303 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1083846380 | Kate Macqueen Marshall Phd PC | Clinic/Center | 1517 Easy Rider Ln Apt 201, Boulder, CO 80304-8406 | 2009-08-20 |
| 1023262532 | Jama Ellen Briscoe, Ph.d., Pllc | Clinic/Center | 2501 Walnut St, Suite 210, Boulder, CO 80302-5751 | 2008-11-11 |
| 1003090929 | Ben Cohen, Ph.d., P.C. | Clinic/Center | 1634 Walnut St, Suite 221, Boulder, CO 80302-5400 | 2007-12-27 |
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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.