Organization
UNIVERSITY OF UTAH PEDIATRIC BEHAVIORAL HEALTH SERVICES
Active
Other names
Pediatric Sports Psychiatry
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNINE RUSHTON (DIRECTOR)
(801) 587-6463
Entity
Organization
Contact information
Practice address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-7109
Mailing address
PO BOX 841450, LOS ANGELES, CA 90084-1450
Taxonomy
Speciality
Code
Description
License number
State
2084S0010X
Sports Medicine (Psychiatry & Neurology) Physician
Primary
—
—
Other
Enumeration date
10/28/2025
Last updated
10/28/2025
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