1588570956 NPI number — PEDIATRIC & MATERNAL BEHAVIORAL HEALTH DBA UPHOLD BEHAVIORAL HEALTH

Table of content: BERNADETTE LORI JENKINS OPTICIAN (NPI 1538988035)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588570956 NPI number — PEDIATRIC & MATERNAL BEHAVIORAL HEALTH DBA UPHOLD BEHAVIORAL HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PEDIATRIC & MATERNAL BEHAVIORAL HEALTH DBA UPHOLD BEHAVIORAL HEALTH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588570956
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/24/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2513 ELMIRA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AURORA
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80010-1164
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-667-7098
Provider Business Mailing Address Fax Number:
720-362-2605

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2513 ELMIRA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80010-1164
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-223-1373
Provider Business Practice Location Address Fax Number:
720-362-2605
Provider Enumeration Date:
08/24/2026

Additional Information

Authorized Official

Authorized Official Last Name:
NUDD
Authorized Official First Name:
SARAH
Authorized Official Middle Name:
EILEEN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
303-667-7098

Provider Taxonomy Codes

  • Taxonomy code: 2084P0804X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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