Active NPI
Jennifer A Chrystan, PH.D.
- Clinical Psychologist
- Park City, UT
National Provider Identifier
1982834800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 7364547-250427
- Practice address
- 2760 Rasmussen Rd Ste 205
Park City, UT 84098-5685 - Phone
- (801) 688-3743
- NPI assigned
- Jul 27, 2009
- 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 Psychologist | 103TC0700X | 7364547-250427 | UT | Primary |
Addresses
Primary practice location
2760 Rasmussen Rd Ste 205
Park City, UT 84098-5685
Mailing address
2760 Rasmussen Rd Ste 205
Park City, UT 84098-5685
Phone (801) 688-3743
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7364547-250427 | UT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248652800000",
"number": "1982834800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2760 RASMUSSEN RD STE 205",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840985685",
"telephone_number": "801-688-3743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2760 RASMUSSEN RD STE 205",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840985685",
"telephone_number": "801-688-3743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHRYSTAN",
"first_name": "JENNIFER",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-27",
"last_updated": "2009-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "UT",
"license": "7364547-250427",
"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 Jul 27, 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.