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NPI Code Detail

MEDICARE: MR. DANIEL AARON ONTIVEROS L.C.S.W.

MEDICARE: MR. DANIEL AARON ONTIVEROS L.C.S.W.
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
11041C0700XClinical Social Worker5034190-3502UT
21041S0200XSchool Social Worker5034190-3502UT
31041C0700XClinical Social Worker5034190-3501UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1107037776101OTHERUTINTRMTN. HEALTH CARE
2898653OTHERUTDESERET MUTUAL
3942938348DSSOTHERUTEDUCATORS MUTUAL

General Provider Information

NPI Number : 1447238456
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DANIEL AARON ONTIVEROS L.C.S.W.
Provider Business Mailing Address
First Line : 1435 E 4230 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84124-2522
Country : US
Telephone Number : 801-274-1065
Fax Number :
Provider Business Practice Location Address
First Line : 5770 S 1500 W
Second Line :
City : TAYLORSVILLE
State : UT
Zip : 84123-5216
Country : US
Telephone Number : 801-313-7770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2006
Last Update Date : 04/24/2023

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