Healthcare Provider Details

I. General information

NPI: 1396943494
Provider Name (Legal Business Name): YOHANNA SACHIKO VERNON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 W 465 N
PROVIDENCE UT
84332-8002
US

IV. Provider business mailing address

PO BOX 5546
DENVER CO
80217-5546
US

V. Phone/Fax

Practice location:
  • Phone: 385-238-3900
  • Fax: 385-238-3901
Mailing address:
  • Phone: 801-475-3500
  • Fax: 801-475-3494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number8612478-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: