Healthcare Provider Details

I. General information

NPI: 1821394842
Provider Name (Legal Business Name): JULIO C JARVIS C.S.W.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2011
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6995 S TOURIST LN APT 12
WEST JORDAN UT
84081-3737
US

IV. Provider business mailing address

PO BOX 162
WEST JORDAN UT
84084-0162
US

V. Phone/Fax

Practice location:
  • Phone: 801-577-0461
  • Fax:
Mailing address:
  • Phone: 801-871-5728
  • Fax: --

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7969592-3502
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: