Healthcare Provider Details

I. General information

NPI: 1750227070
Provider Name (Legal Business Name): ALEXIS ROSINA HERRERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3784 W VALLEY VIEW DR
CEDAR HILLS UT
84062-8085
US

IV. Provider business mailing address

1368 S 1500 E
PROVO UT
84606-6549
US

V. Phone/Fax

Practice location:
  • Phone: 801-407-9998
  • Fax:
Mailing address:
  • Phone: 385-241-5798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberF26-151986
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: