Provider Demographics
NPI:1720455504
Name:GOSTISHCHEVA, YULIYA
Entity Type:Individual
Prefix:
First Name:YULIYA
Middle Name:
Last Name:GOSTISHCHEVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 S PARKER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-2163
Mailing Address - Country:US
Mailing Address - Phone:720-282-3578
Mailing Address - Fax:720-282-3579
Practice Address - Street 1:1210 S PARKER RD STE 200
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-2163
Practice Address - Country:US
Practice Address - Phone:720-282-3578
Practice Address - Fax:303-963-5641
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-27
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO261QA0600X
CO04B433376J00000X, 385H00000X
172A00000X
CO04T569253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No376J00000XNursing Service Related ProvidersHomemaker
No385H00000XRespite Care FacilityRespite Care
No172A00000XOther Service ProvidersDriver