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NPI Code Detail

MEDICARE: JACINTA TAYLOR CPSS, FPSS, SSW

MEDICARE: JACINTA TAYLOR CPSS, FPSS, SSW
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
1104100000XSocial Worker138482723503UT

General Provider Information

NPI Number : 1568059509
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACINTA TAYLOR CPSS, FPSS, SSW
Provider Business Mailing Address
First Line : 750 N FREEDOM BLVD
Second Line :
City : PROVO
State : UT
Zip : 84601-1677
Country : US
Telephone Number : 801-373-4760
Fax Number : 801-373-0639
Provider Business Practice Location Address
First Line : 750 N FREEDOM BLVD
Second Line :
City : PROVO
State : UT
Zip : 84601-1677
Country : US
Telephone Number : 801-373-4760
Fax Number : 801-373-0639
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2020
Last Update Date : 02/08/2026

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