MEDICARE: JASMINE G GIRGENTI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	1041C0700X	Clinical Social Worker	13576527-3502	UT

General Provider Information

NPI Number	:	1245897081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE G GIRGENTI

Provider Business Mailing Address
First Line	:	807 E SOUTH TEMPLE STE 200
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-1446
Country	:	US
Telephone Number	:	385-200-0535
Fax Number	:

Provider Business Practice Location Address
First Line	:	807 E SOUTH TEMPLE STE 200
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-1446
Country	:	US
Telephone Number	:	385-200-0535
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2019
Last Update Date	:	06/24/2025

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Directions to “ JASMINE G GIRGENTI ” Practice Location

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