Individual
GENEAL HERRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1020 S MAIN ST, SALT LAKE CITY, UT 84101-3176
(888) 949-4864
Mailing address
3725 W 4100 S STE 201, WEST VALLEY CITY, UT 84120-6490
(888) 949-4864
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
F21-102765
UT
175T00000X
Peer Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000055266
MEDICARE PIN
UT
01
—
260022408
MEDICARE RAILROAD
UT
05
—
8760003008007
—
UT
Enumeration date
07/13/2018
Last updated
07/09/2025
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