Individual provider Active NPI

Diego Gonzalo Flores, PH.D.

  • Psychologist
  • Murray, UT
National Provider Identifier
1205581832
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
12310540-2504 Issued in UT
Practice address
111 E 5600 S Ste 304
Murray, UT 84107-8174
Phone
(801) 272-3420
NPI assigned
Feb 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 12310540-2504 UT Primary

Addresses

Primary practice location

111 E 5600 S Ste 304
Murray, UT 84107-8174

Mailing address

111 E 5600 S Ste 304
Murray, UT 84107-8174
Phone (801) 272-3420

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
12310540-2504UTMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Connections Counseling Services CurrentSince Feb 13, 2022 Accepting new patients

Locations

111 E 5600 S
Ste 304
Murray, UT 84107
Phone (801) 272-3420

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1205581832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 5600 S STE 304",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841078174",
            "telephone_number": "801-272-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 5600 S STE 304",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841078174",
            "telephone_number": "801-272-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "DIEGO",
        "middle_name": "GONZALO",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-11",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "UT",
            "license": "12310540-2504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.