Tara Sharifan, PSYD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

10476501-2501 Issued in UT

Practice address

505 S Main St Ste 209
Bountiful, UT 84010-6398

Phone

(385) 244-0055

NPI assigned

Aug 9, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Wasatch Front Wellness, PLLC

  • Clinical Psychologist
  • North Salt Lake, UT
  • NPI 1023627759
  NPD Authorized official
• Resolutions, Inc.

  • Counselor
  • Bountiful, UT
  • NPI 1457790081
  NPD (past) Authorized official

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513728000000",
    "number": "1356620264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 GARY WAY",
            "city": "NORTH SALT LAKE",
            "state": "UT",
            "postal_code": "840541534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S MAIN ST STE 209",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106398",
            "telephone_number": "385-244-0055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2275 Arlington Dr",
            "address_purpose": "LOCATION",
            "city": "San Leandro",
            "state": "CA",
            "postal_code": "945781132",
            "country_code": "US",
            "telephone_number": "510-317-1444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHARIFAN",
        "first_name": "TARA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-09",
        "last_updated": "2017-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "UT",
            "license": "10476501-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chloe Rose Sell
• Daniel Shane Sellers, M.D.
• Jessica Irazu Serhan-Garcilazo
• Rhett Shamo, OTR/L
• Shared Expectations PLLC
• Lisa Ann Sharp, FNP
• Brooke Sheffer
• Megan Eidenshink Shelly
• Elisabeth Sheridan, LCSW
• Rosemary Elin Sherlock, LCSW

• Clinical Child & Adolescent Psychologist in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Clinical Child & Adolescent Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2017; 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.