Individual provider Active NPI

Jennifer Gale, PSY.D.

  • Clinical Neuropsychologist
  • Park City, UT
National Provider Identifier
1942473517
Registry record updated Apr 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
377761-2501 Issued in UT
Practice address
1910 Prospector Ave
Suite 201
Park City, UT 84060-7211
Phone
(435) 645-9240
Fax
(435) 645-9237
NPI assigned
Apr 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 377761-2501 UT Primary

Addresses

Primary practice location

1910 Prospector Ave
Suite 201
Park City, UT 84060-7211

Mailing address

1910 Prospector Ave
Suite 201
Park City, UT 84060-7211
Phone (435) 645-9240

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
377761-2501UTMDClinical Neuropsychologist

NPI Registry JSON

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207180800000",
    "number": "1942473517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 PROSPECTOR AVE",
            "address_2": "SUITE 201",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607211",
            "telephone_number": "435-645-9240",
            "fax_number": "435-645-9237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 PROSPECTOR AVE",
            "address_2": "SUITE 201",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607211",
            "telephone_number": "435-645-9240",
            "fax_number": "435-645-9237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALE",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-03",
        "last_updated": "2008-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "UT",
            "license": "377761-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; 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.