Provider Demographics
NPI:1497075451
Name:CLAVIJO, FRANK D (PH D)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:D
Last Name:CLAVIJO
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 S SABLE BLVD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-3796
Mailing Address - Country:US
Mailing Address - Phone:720-858-9111
Mailing Address - Fax:720-858-1199
Practice Address - Street 1:1090 S SABLE BLVD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-3796
Practice Address - Country:US
Practice Address - Phone:720-858-9111
Practice Address - Fax:720-858-1199
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6304101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)