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NPI Code Detail

MEDICARE: DR. AMIRA TREVINO PHD

MEDICARE: DR. AMIRA TREVINO PHD
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
1103T00000XPsychologist14218034-2501UT
2101YM0800XMental Health CounselorCG60564199WA

General Provider Information

NPI Number : 1851771745
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMIRA TREVINO PHD
Provider Business Mailing Address
First Line : 4568 S HIGHLAND DR STE 380
Second Line :
City : MILLCREEK
State : UT
Zip : 84117-4213
Country : US
Telephone Number : 385-867-3581
Fax Number :
Provider Business Practice Location Address
First Line : 4568 S HIGHLAND DR STE 380
Second Line :
City : MILLCREEK
State : UT
Zip : 84117-4213
Country : US
Telephone Number : 385-458-8947
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2015
Last Update Date : 02/20/2026

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