Healthcare Provider Details

I. General information

NPI: 1164141941
Provider Name (Legal Business Name): SILVANA MARTINEZ PIZARRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 S DIXIE DR APT 14F
WEST JORDAN UT
84084-1050
US

IV. Provider business mailing address

6330 S DIXIE DR APT 14F
WEST JORDAN UT
84084-1050
US

V. Phone/Fax

Practice location:
  • Phone: 385-549-6282
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13989217-3501
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: