Anne F Taverne, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

363423-2501 Issued in UT

Practice address

5242 So. 4820 W.
The Children'S Center
SLC, UT 84118-6422

Phone

(801) 966-4251

NPI assigned

Apr 22, 2008

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

Other identifiers 1

Other names 1

• Anne Fuller Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253145600000",
    "number": "1780858662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5242 SO. 4820 W.",
            "address_2": "THE CHILDREN'S CENTER",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841186422",
            "telephone_number": "801-966-4251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5242 SO. 4820 W.",
            "address_2": "THE CHILDREN'S CENTER",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841186422",
            "telephone_number": "801-966-4251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVERNE",
        "first_name": "ANNE",
        "middle_name": "F",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-22",
        "last_updated": "2009-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "UT",
            "license": "363423-2501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1780858662",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNE",
            "last_name": "FULLER",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Randal W Swenson, MD
• Shalonda Sykes
• Carla Tang, PMHNP-BC
• Chuck Y Tang, PHARM D.
• Richard E Tanski, LSUDC
• Amanda Taylor
• Emily Taylor
• Isabella Oscar Hedwig Tcaciuc, M.D.
• Hayle Teal, RBT
• Tasha Teal, RBT

• Psychologist in SLC, UT
• Providers in SLC, UT by specialty
• Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; 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.