Healthcare Provider Details

I. General information

NPI: 1467377200
Provider Name (Legal Business Name): SILVANA ROMINA SANTA CRUZ CRUZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 W 520 N
OREM UT
84057-4695
US

IV. Provider business mailing address

31 S 1300 W
PLEASANT GROVE UT
84062-3789
US

V. Phone/Fax

Practice location:
  • Phone: 801-224-1103
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13204342-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: