Healthcare Provider Details

I. General information

NPI: 1699211466
Provider Name (Legal Business Name): HEALTH PSYCHOLOGY ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2017
Last Update Date: 01/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2911 W ALLRED CIR
TAYLORSVILLE UT
84129-2213
US

IV. Provider business mailing address

2911 W ALLRED CIR
TAYLORSVILLE UT
84129-2213
US

V. Phone/Fax

Practice location:
  • Phone: 801-842-3165
  • Fax: 801-581-6243
Mailing address:
  • Phone: 801-842-3156
  • Fax: 801-581-6243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3393702501
License Number StateUT

VIII. Authorized Official

Name: ERIC A YELSA
Title or Position: OWNER
Credential: PHD
Phone: 801-842-3156