Individual provider Active NPI

Luana Magdalena Nan, PHD

  • Psychologist
  • Salt Lake City, UT
National Provider Identifier
1174746994
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
11353124-2501 Issued in UT
Practice address
201 S 1460 E RM 426
Salt Lake City, UT 84112-9061
Phone
(801) 581-6826
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 11353124-2501 UT Primary

Addresses

Primary practice location

201 S 1460 E RM 426
Salt Lake City, UT 84112-9061

Mailing address

9477 S Lennox Cir
South Jordan, UT 84009-2752
Phone (317) 385-9741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
11353124-2501UTMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1174746994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9477 S LENNOX CIR",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840092752",
            "telephone_number": "317-385-9741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S 1460 E RM 426",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841129061",
            "telephone_number": "801-581-6826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAN",
        "first_name": "LUANA",
        "middle_name": "MAGDALENA",
        "name_prefix": "Mrs.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "UT",
            "license": "11353124-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.