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NPI Code Detail

MEDICARE: JULIO C JARVIS C.S.W.

MEDICARE: JULIO C JARVIS 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
1171M00000XCase Manager/Care Coordinator
21041C0700XClinical Social Worker7969592-3502UT

General Provider Information

NPI Number : 1821394842
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIO C JARVIS C.S.W.
Provider Business Mailing Address
First Line : 32 W WINCHESTER ST
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84107
Country : US
Telephone Number : 801-263-6367
Fax Number : 801-263-6370
Provider Business Practice Location Address
First Line : 32 W WINCHESTER ST
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84107-5607
Country : US
Telephone Number : 801-263-6367
Fax Number : 801-263-6370
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2011
Last Update Date : 07/21/2022

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