Individual
MS. VANESSA N/A VALLEJOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
500 FOOTHILL DR, SALT LAKE CITY, UT 84148-1975
(801) 582-1565
Mailing address
500 FOOTHILL DRIVE, SALT LAKE CITY, UT 84148
(801) 582-1565
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
61649666
WA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
61649666
WA
Other
Enumeration date
01/03/2025
Last updated
04/15/2025
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