Active NPI
Janis Di Ciacco, PH.D.
- Clinical Psychologist
- Denver, CO
National Provider Identifier
1720127160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1053
- Practice address
- 461 Magnolia St
Denver, CO 80220-6011 - Phone
- (303) 321-4184
- NPI assigned
- Feb 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1053 | CO | Primary |
Addresses
Primary practice location
461 Magnolia St
Denver, CO 80220-6011
Mailing address
461 Magnolia St
Denver, CO 80220-6011
Phone (303) 321-4184
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07010531 | Medicaid | CO | |
| 8137-6 | Other | CO | BLUE CROSS/BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1053 | CO | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270080000000",
"number": "1720127160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "461 MAGNOLIA ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802206011",
"telephone_number": "303-321-4184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "461 MAGNOLIA ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802206011",
"telephone_number": "303-321-4184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DI CIACCO",
"first_name": "JANIS",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2010-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "1053",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07010531",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "8137-6",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.