Provider Demographics
NPI:1235318809
Name:BOLDUAN LOMAX, JANA MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JANA
Middle Name:MARIE
Last Name:BOLDUAN LOMAX
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MISS
Other - First Name:JANA
Other - Middle Name:MARIE
Other - Last Name:BOLDUAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 6510, MAIL STOP F-704
Mailing Address - Street 2:ACP 2253 A
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-0510
Mailing Address - Country:US
Mailing Address - Phone:720-848-1611
Mailing Address - Fax:720-848-0359
Practice Address - Street 1:1665 URSULA ST
Practice Address - Street 2:MAIL STOP F-704, ACP 2253 A
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7402
Practice Address - Country:US
Practice Address - Phone:720-848-1611
Practice Address - Fax:720-848-0359
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3145103T00000X, 103TB0200X, 103TC0700X, 103TC1900X, 103TH0004X, 103TH0100X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy