Healthcare Provider Details

I. General information

NPI: 1679487185
Provider Name (Legal Business Name): RAY ANTHONY SAHAGUN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 N MAIN ST
CEDAR CITY UT
84721-9811
US

IV. Provider business mailing address

2123 E MOUNTAIN VIEW LOOP
ENOCH UT
84721-1375
US

V. Phone/Fax

Practice location:
  • Phone: 801-382-9338
  • Fax: 801-383-0246
Mailing address:
  • Phone: 435-592-2455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14206052-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: