Healthcare Provider Details

I. General information

NPI: 1801790894
Provider Name (Legal Business Name): ALICIA C ROBINSON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 E 11400 S STE 102
SANDY UT
84094-6947
US

IV. Provider business mailing address

11758 S AUTUMN RIDGE DR
SANDY UT
84092-7341
US

V. Phone/Fax

Practice location:
  • Phone: 916-220-5189
  • Fax:
Mailing address:
  • Phone: 916-220-5189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10330609-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: