Provider Demographics
NPI:1821128059
Name:HOLDEN, JENNIFER FRISCHKNECHT (JD, PSYD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:FRISCHKNECHT
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:JD, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2502 W COLORADO AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-3068
Mailing Address - Country:US
Mailing Address - Phone:415-939-1060
Mailing Address - Fax:
Practice Address - Street 1:2502 W COLORADO AVE STE 201
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-3068
Practice Address - Country:US
Practice Address - Phone:415-939-1060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 21713103TC0700X
CO3507103TC0700X
WA26465173000000X
UT7856173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO12217544OtherCAQH ID