1891955936 NPI number — DEBORAH A CHRISTENSEN PHD & ASSOCIATES, INC

Table of content: (NPI 1891955936)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891955936 NPI number — DEBORAH A CHRISTENSEN PHD & ASSOCIATES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DEBORAH A CHRISTENSEN PHD & ASSOCIATES, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891955936
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/26/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
248 EAST 13800 SOUTH
Provider Second Line Business Mailing Address:
SUITE 4
Provider Business Mailing Address City Name:
DRAPER
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84020
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-816-1801
Provider Business Mailing Address Fax Number:
801-501-0249

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
248 EAST 13800 SOUTH
Provider Second Line Business Practice Location Address:
SUITE 4
Provider Business Practice Location Address City Name:
DRAPER
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-816-1801
Provider Business Practice Location Address Fax Number:
801-501-0249
Provider Enumeration Date:
06/12/2008

Additional Information

Authorized Official

Authorized Official Last Name:
CORTEZ
Authorized Official First Name:
JULIAN
Authorized Official Middle Name:
Authorized Official Title or Position:
LEAD CREDENTIALING SPECIALIST
Authorized Official Telephone Number:
619-781-2418

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  89-115803-2501 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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