Healthcare Provider Details

I. General information

NPI: 1447176755
Provider Name (Legal Business Name): SARA NEFTALY GOMEZ VILLALOBOS CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARA GOMEZ CSW

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3051 W MAPLE LOOP DR STE 300
LEHI UT
84048-6552
US

IV. Provider business mailing address

3051 W MAPLE LOOP DR STE 300
LEHI UT
84048-6552
US

V. Phone/Fax

Practice location:
  • Phone: 801-405-7450
  • Fax: 385-446-2650
Mailing address:
  • Phone: 801-405-7450
  • Fax: 385-446-2650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number13585856-3502
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: