GENEAL HERRERA (NPI# 1174009005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174009005 |
| Entity Type | Individual |
| Full Name | GENEAL HERRERA |
| Practice Address |
4460 S Highland Dr Ste 210 Salt Lake City UT 84124-3550 |
| Practice Telephone | 8889494864 |
| Mailing Telephone | 8889494864 |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2019-07-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | MEDICARE RAILROAD | 260022408 | 01 |
| UT | MEDICARE PIN | 000055266 | 01 |
| UT | 8760003008007 | 05 |
| Street Address |
4460 S HIGHLAND DR STE 210 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84124-3550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912077629 | Charmaine Regina Stapfer | Counselor | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124 | 2006-11-09 |
| 1679174908 | Theresa Furbish | Nurse Practitioner | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-11-03 |
| 1841891173 | Anastasia Holmen | Case Manager/Care Coordinator | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-11-03 |
| 1740881077 | Marianne Longoria | Case Manager/Care Coordinator | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-11-03 |
| 1700487048 | Michelle Teresa Wilcock | Pharmacy Technician | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-11-03 |
| 1730780065 | Wilson Lee | Case Manager/Care Coordinator | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-11-03 |
| 1952901837 | Brenda Sariah Lopez | Case Manager/Care Coordinator | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-10-29 |
| 1437759669 | Ian Grant White | Case Manager/Care Coordinator | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-10-27 |
| 1528668035 | Carina Terry | Case Manager/Care Coordinator | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-10-26 |
| 1114526282 | Alishka Khaosanga | Case Manager/Care Coordinator | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487273298 | Shannon Penny Price | Social Worker | 4465 Maybeck Place, Condo C, Millcreek, UT 84124 | 2020-04-11 |
| 1922654367 | Joseph C Melvin Md PC | Colon & Rectal Surgery | 1250 East 3900 South Ste 320, Salt Lake City, UT 84124 | 2019-08-12 |
| 1366923252 | Melanie Stumpf | Counselor | 1141 E 3900, Suite A170, Salt Lake City, UT 84124 | 2018-08-28 |
| 1376033993 | Michelle Flowers | Speech-Language Pathologist | 2120 East 3900 South, Ste 200, Holladay, UT 84124 | 2018-05-18 |
| 1740797257 | Lissa Anne Hutchings | Nurse Practitioner | 1160 E 3900 S Ste 4100, Salt Lake City, UT 84124 | 2018-01-05 |
| 1316465693 | Randy Gines | Counselor | 4460 S Highland Drive # 230, Murray, UT 84124 | 2017-09-06 |
| 1417470717 | Joshua Chandler Spencer | Counselor | 4460 South Highland Dr., 230, Murray, UT 84124 | 2017-07-19 |
| 1659891554 | Marcus Whitney | Counselor | 4460 S Highland Dr. # 230, Murray, UT 84124 | 2017-06-21 |
| 1518496884 | Courtney Nilson | Counselor | 4460 S. Highland Dr. #230, Murray, UT 84124 | 2017-06-08 |
| 1841687126 | Intrafilrx | Preferred Provider Organization | 3920 S 1100 E Ste 210, Salt Lake City, UT 84124 | 2015-04-23 |
| Find all providers in zip 84124 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043819600 | Devin J Morrison | Peer Specialist | 230 W 200 S Unit 142, Salt Lake City, UT 84110-6006 | 2020-10-23 |
| 1518579077 | Henry Matthews | Peer Specialist | 474 N Grant St, Salt Lake City, UT 84116-2726 | 2020-08-17 |
| 1134780042 | Michael James Olsen | Peer Specialist | 344 E 100 S Ste 301300, Salt Lake City, UT 84111-1700 | 2019-06-23 |
| 1659836393 | Brittney Emi Vaovasa | Peer Specialist | 252 W Brooklyn Ave, Salt Lake City, UT 84101-3024 | 2019-02-06 |
| 1306348263 | Kurt Kyle Landenberger | Peer Specialist | 2200 S State St Fl 2, Salt Lake City, UT 84115-2724 | 2018-03-06 |
| 1922609320 | Teri Christensen | Peer Specialist | 230 W 200 S # 142, Salt Lake City, UT 84101-1337 | 2020-11-03 |
| 1821698713 | Kim Katherine Stephens | Peer Specialist | 230 W 200 S # 142, Salt Lake City, UT 84101-1337 | 2020-10-29 |
| 1225638364 | Anna Elizabeth Dees | Peer Specialist | 230 W 200 S Ste 142, Salt Lake City, UT 84101-1337 | 2020-10-28 |
| 1124628268 | Amber Wilkins I | Peer Specialist | 230 W 200 S # 142, Salt Lake City, UT 84101-1337 | 2020-10-28 |
| 1811596885 | Kaylie A Larsen | Peer Specialist | 230 W 200 S # 142, Salt Lake City, UT 84101-1337 | 2020-10-21 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84124 |
Please comment or provide details below to improve the information on GENEAL HERRERA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.