Active NPI
Fabiola Marquez Jamieson, LCSW
- Clinical Social Worker
- Holladay, UT
National Provider Identifier
1821348640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 73763963501
- Practice address
- 4500 S 2180 E
Suite 165
Holladay, UT 84117 - Phone
- (801) 461-9060
- NPI assigned
- Sep 19, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 73763963501 | UT | Primary |
Addresses
Primary practice location
4500 S 2180 E
Suite 165
Holladay, UT 84117
Mailing address
823 2ND Ave
Apt B
Salt Lake City, UT 84103
Phone (801) 360-5191
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
| License | State | Type | Specialty |
|---|---|---|---|
| 73763963501 | UT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348012800000",
"number": "1821348640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "823 2ND AVE",
"address_2": "APT B",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "84103",
"telephone_number": "801-360-5191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 S 2180 E",
"address_2": "SUITE 165",
"city": "HOLLADAY",
"state": "UT",
"postal_code": "84117",
"telephone_number": "801-461-9060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMIESON",
"first_name": "FABIOLA",
"middle_name": "MARQUEZ",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-19",
"last_updated": "2012-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "73763963501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holladay, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.