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NPI Code Detail

MEDICARE: SHAON PRIMUS

MEDICARE: SHAON PRIMUS
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
1106H00000XMarriage & Family Therapist118439883904UT

General Provider Information

NPI Number : 1255622460
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAON PRIMUS
Provider Business Mailing Address
First Line : 5155 S SANDPIPER DR APT 402
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84117-4725
Country : US
Telephone Number : 801-888-9640
Fax Number :
Provider Business Practice Location Address
First Line : 5965 S 900 E
Second Line :
City : MURRAY
State : UT
Zip : 84121-1720
Country : US
Telephone Number : 801-232-7138
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2011
Last Update Date : 03/06/2026

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Directions to “ SHAON PRIMUS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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