Provider Demographics
NPI:1083224695
Name:AGUILON, JANELLE ADRIENNE CENDANA (APRN-CNP, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:JANELLE ADRIENNE
Middle Name:CENDANA
Last Name:AGUILON
Suffix:
Gender:F
Credentials:APRN-CNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:#1075 1601 29TH ST
Mailing Address - Street 2:SUITE 1292
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301
Mailing Address - Country:US
Mailing Address - Phone:720-994-4810
Mailing Address - Fax:720-994-4811
Practice Address - Street 1:#1075 1601 29TH ST
Practice Address - Street 2:SUITE 1292
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301
Practice Address - Country:US
Practice Address - Phone:720-994-4810
Practice Address - Fax:720-994-4811
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-07
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1666993163W00000X
COAPN.0995770-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse