MR. MATTHEW VANDENBERG (NPI# 1174669949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174669949 |
| Entity Type | Individual |
| Full Name | MR. MATTHEW VANDENBERG |
| Credential | CPHT |
| Practice Address |
500 Foothill Blvd Salt Lake City UT 84148-0001 |
| Mailing Address |
4158 Berridale Cir South Jordan UT 84095-9102 |
| Practice Telephone | 8015821565 |
| Mailing Telephone | 8015821565 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183700000X | Pharmacy Technician | Pharmacy Service Providers |
| Street Address |
500 FOOTHILL BLVD |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84148-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376547646 | Terri Evans | Pharmacist | 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2005-06-02 |
| 1841818325 | Abigale Briscoe | Pharmacist | 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2020-07-10 |
| 1053947804 | Channing Jovi Cochran | Psychologist | 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2020-03-12 |
| 1972138337 | Ryan Scott | Registered Nurse | 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2020-03-05 |
| 1932756319 | Christine Rosner | Psychologist | 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2019-08-21 |
| 1770137994 | Courtney Sedillo | Nurse Practitioner | 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2019-07-25 |
| 1942866991 | Erika Jill Smith | Dietitian, Registered | 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2019-05-15 |
| 1629548854 | Nicole Legarreta | Social Worker | 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2018-11-30 |
| 1780159269 | Jill Henningfeld | Nurse Practitioner | 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2018-10-10 |
| 1275010035 | Leigh-andrew Thomas Sampson-seitz | Registered Nurse | 500 Foothill Blvd, Salt Lake City, UT 84148 | 2018-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598211799 | Jacquelyn Rae Contant | Dietitian, Registered | 500 Foothill Dr. (120), Salt Lake City, UT 84148 | 2016-08-28 |
| 1699127811 | Taylor Alford | Pharmacist | 500 Foothills Drive, Salt Lake City, UT 84148 | 2016-07-12 |
| 1356792162 | Sarah Hummel | Genetic Counselor, MS | 500 Foothill Drive, Sarah Hummel, Va Salt Lake City, Genomic Medicine (10p4e), Salt Lake City - Salt Lake, UT 84148 | 2016-06-23 |
| 1174936140 | Elizabeth Shade Cardenas | Nurse Practitioner | 500 Foothill Drive #182h, Veterans Healthcare Administration, Salt Lake City, UT 84148 | 2014-06-08 |
| 1386904043 | David Earl Moore | Specialist | 500 Foothill Blvd (research), George E. Wahlen Va Healthcare System, Salt Lake City, UT 84148 | 2012-05-29 |
| 1790059038 | Deborah Ernstein Holley Hartzfeld | Genetic Counselor, MS | 615 Arapeen Drive #212, Salt Lake City, UT 84148 | 2012-03-05 |
| 1073823720 | Diana Lynn Robbins | Social Worker | 9140 W. Post Road, Las Vegas, NV 84148 | 2010-10-15 |
| 1659534394 | Katherine Margaret Dunn | Genetic Counselor, MS | 500 Foothill Drive (151z), Salt Lake City, UT 84148 | 2008-07-02 |
| 1730381625 | Douglas James Ball | Medical Genetics | Va Salt Lake City Health Care System 10p11, Salt Lake City, UT 84148 | 2007-06-03 |
| 1245339530 | Daniel H Priestly | Radiology | 500 Foothill Dr., Salt Lake City, UT 84148 | 2006-09-22 |
| Find all providers in zip 84148 | ||||
| Taxonomy Code | 183700000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacy Technician |
| A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |
| Notes: Source: Pharmacy Technician Certification Board, www.ptcb.org [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245796358 | Crystal Paredes | Pharmacy Technician | 1020 S Main St Ste 110, Salt Lake City, UT 84101-3176 | 2019-02-13 |
| 1982144341 | Sharlena Schacht | Pharmacy Technician | 1040 North 2200 West, Salt Lake City, UT 84116 | 2017-03-06 |
| 1588724397 | Jolley's Corner Variety, Inc. | Pharmacy Technician | 1676 E 1300 S, Salt Lake City, UT 84105-1704 | 2006-12-11 |
| 1265546584 | Jason Allen Dunn | Pharmacy Technician | 1260 E Vine St, Salt Lake City, UT 84121 | 2006-08-17 |
| 1700487048 | Michelle Teresa Wilcock | Pharmacy Technician | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-11-03 |
| 1023621232 | Thomas Alan Good Lance White Bull | Pharmacy Technician | 500 Foothill Dr, Salt Lake City, UT 84148-0001 | 2020-08-26 |
| 1073125373 | Brenda Lee Waller | Pharmacy Technician | 729 N Redwood Rd, Salt Lake City, UT 84116-1909 | 2020-08-18 |
| 1134738792 | Bailee Marie Anderson | Pharmacy Technician | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-07-29 |
| 1538788013 | Andrew Ronald Johnson | Pharmacy Technician | 500 Foothill Dr, Salt Lake City, UT 84148-0001 | 2020-04-14 |
| 1821562760 | Christopher Davis | Pharmacy Technician | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2019-01-14 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84148 |
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| 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.