# UNIVERSITY OF UTAH PEDIATRIC BEHAVIORAL HEALTH SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** UNIVERSITY OF UTAH PEDIATRIC BEHAVIORAL HEALTH SERVICES
- **Other names:** Neurostimulation Clinic - Pediatric Adolescent
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1033573191
- **Legal business name:** UNIVERSITY OF UTAH PEDIATRIC BEHAVIORAL HEALTH SERVICES
- **Authorized official:** JON KAR ZUBIETA MD (DEPARTMENT CHAIR)
- **Authorized official phone:** (801) 587-6336

## Contact information

- **Practice address:** 501 S CHIPETA WAY, SALT LAKE CITY, UT 84108-1222
- **Practice address phone:** (801) 587-6336
- **Mailing address:** PO BOX 413021, SALT LAKE CITY, UT 84141-3021
- **Mailing address phone:** (801) 587-6336

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084N0008X | Neuromuscular Medicine (Psychiatry & Neurology) Physician | — | NULL | — |
| 2084N0008X | Neuromuscular Medicine (Psychiatry & Neurology) Physician | — | — | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/05/2016
- **Last updated:** 04/06/2016