Provider Demographics
NPI:1396970067
Name:PEREIRA, VICTORIA (NCTMB)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:
Last Name:PEREIRA
Suffix:
Gender:F
Credentials:NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 US HIGHWAY 287 UNIT 100
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-7076
Mailing Address - Country:US
Mailing Address - Phone:303-638-6695
Mailing Address - Fax:
Practice Address - Street 1:1140 US HIGHWAY 287 UNIT 100
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-7076
Practice Address - Country:US
Practice Address - Phone:303-638-6695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-22
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT-7936172M00000X
COMT7936225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No172M00000XOther Service ProvidersMechanotherapist