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NPI Code Detail

MEDICARE: KATHLEEN MARIA ATENCIO

MEDICARE: KATHLEEN MARIA ATENCIO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker13991296-3501UT
2104100000XSocial Worker13991296-3501UT

General Provider Information

NPI Number : 1386368157
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN MARIA ATENCIO
Provider Business Mailing Address
First Line : 344 E 100 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84111-1700
Country : US
Telephone Number : 801-428-4257
Fax Number :
Provider Business Practice Location Address
First Line : 344 E 100 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84111-1700
Country : US
Telephone Number : 801-428-4257
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2022
Last Update Date : 03/09/2026

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Directions to “ KATHLEEN MARIA ATENCIO ” Practice Location

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