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NPI Code Detail

MEDICARE: SARAH JEAN CARDENAS BCBA

MEDICARE: SARAH JEAN CARDENAS BCBA
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
1103K00000XBehavior Analyst14190035-2506UT

General Provider Information

NPI Number : 1639991664
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH JEAN CARDENAS BCBA
Provider Business Mailing Address
First Line : 3212 S 2000 E
Second Line :
City : MILLCREEK
State : UT
Zip : 84109-2602
Country : US
Telephone Number : 801-842-6111
Fax Number :
Provider Business Practice Location Address
First Line : 2825 E COTTONWOOD PKWY STE 500
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84121-7060
Country : US
Telephone Number : 801-919-8997
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2024
Last Update Date : 10/31/2024

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