Healthcare Provider Details

I. General information

NPI: 1770436271
Provider Name (Legal Business Name): ROHINI CARLSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2026
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 MORRIS AVE STE 100
SALT LAKE CITY UT
84115-3278
US

IV. Provider business mailing address

16255 VENTURA BLVD STE 900
ENCINO CA
91436-2317
US

V. Phone/Fax

Practice location:
  • Phone: 801-935-4171
  • Fax:
Mailing address:
  • Phone: 801-935-4171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: