Provider Demographics
NPI:1538126826
Name:RUMBERGER, DANIEL J (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:RUMBERGER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 W DAVIES AVE N STE 105
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-4287
Mailing Address - Country:US
Mailing Address - Phone:303-730-1717
Mailing Address - Fax:303-730-1531
Practice Address - Street 1:141 W DAVIES AVE N STE 105
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-4287
Practice Address - Country:US
Practice Address - Phone:303-730-1717
Practice Address - Fax:303-730-1531
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA567103T00000X
CO0004932103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN10238RYOtherBLUE CROSS / BLUE SHIELD
IA26537OtherBLUE CROSS / BLUE SHIELD
NE100252270-00Medicaid
A004054OtherCHAMPUS
IA0051847Medicaid
NE100252270-00Medicaid