Organization
ALPINE PEDIATRICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON JAUSSI (ADMINISTRATOR)
(801) 922-9371
Entity
Organization
Contact information
Practice address
1912 W 930 N, PLEASANT GROVE, UT 84062-4104
(801) 492-1999
(801) 922-9370
Mailing address
1912 W 930 N, PLEASANT GROVE, UT 84062-4104
(801) 492-1999
(801) 922-9370
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
208000000X
Pediatrics Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/06/2006
Last updated
03/30/2021
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