Provider Demographics
NPI:1033893607
Name:PAULEZ, JEFF (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEFF
Middle Name:
Last Name:PAULEZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3758 E 104TH AVE # 711
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80233-4434
Mailing Address - Country:US
Mailing Address - Phone:303-578-0708
Mailing Address - Fax:
Practice Address - Street 1:226 REMINGTON ST STE 1
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-7115
Practice Address - Country:US
Practice Address - Phone:303-578-0708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0005354103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist