Individual provider Active NPI

Karen L Dastrup, PSY.D.

  • Marriage & Family Therapist
  • Salt Lake City, UT
National Provider Identifier
1497099535
Registry record updated May 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
7336931-3902 Issued in UT
Practice address
4460 S Highland Dr
Salt Lake City, UT 84124-3543
Phone
(888) 949-4864
NPI assigned
Nov 15, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC37461 CA
Marriage & Family Therapist 106H00000X 7336931-3902 UT Primary

Addresses

Primary practice location

4460 S Highland Dr
Salt Lake City, UT 84124-3543

Mailing address

18411 Crenshaw Blvd Ste 414
Torrance, CA 90504-5065
Phone (310) 225-6707

Other practice location 1

18411 Crenshaw Blvd Ste 414
Torrance, CA 90504-5065
Phone (310) 225-6707

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

State licenses

LicenseStateTypeSpecialty
MFC37461CAMDMarriage & Family Therapist
7336931-3902UTMDMarriage & Family Therapist

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1497099535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18411 CRENSHAW BLVD STE 414",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045065",
            "telephone_number": "310-225-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4460 S HIGHLAND DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841243543",
            "telephone_number": "888-949-4864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18411 Crenshaw Blvd Ste 414",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905045065",
            "country_code": "US",
            "telephone_number": "310-225-6707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DASTRUP",
        "first_name": "KAREN",
        "middle_name": "L",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC37461",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "7336931-3902",
            "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 May 9, 2019; 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.