Healthcare Provider Details

I. General information

NPI: 1912823477
Provider Name (Legal Business Name): FRANCISCO BEDOLLA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11978 S REDWOOD RD
RIVERTON UT
84065-7403
US

IV. Provider business mailing address

5492 W CHANTRY RD # 103
WEST VALLEY CITY UT
84120-5797
US

V. Phone/Fax

Practice location:
  • Phone: 801-792-1057
  • Fax:
Mailing address:
  • Phone: 801-792-1057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: