Healthcare Provider Details

I. General information

NPI: 1699639831
Provider Name (Legal Business Name): VIDA HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11566 S HOLLY SPRINGS DR
SOUTH JORDAN UT
84009-1387
US

IV. Provider business mailing address

945 MARKET ST STE 501
SAN FRANCISCO CA
94103-1701
US

V. Phone/Fax

Practice location:
  • Phone: 801-361-4157
  • Fax:
Mailing address:
  • Phone: 855-442-5885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMY LYNNE GRUBBS
Title or Position: HEALTH COACH
Credential: HEALTH COACH
Phone: 801-361-4157