Fan Lee Kwan, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

369290-3501 Issued in UT

Practice address

7434 S State St
Midvale, UT 84047-2014

Phone

(801) 566-4423

NPI assigned

Jan 25, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1992775415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6294 TERRACE RIDGE DR",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841285604",
            "telephone_number": "801-964-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7434 S STATE ST",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840472014",
            "telephone_number": "801-566-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAN",
        "first_name": "FAN",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "369290-3501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U006",
            "identifier": "107018309101",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ICAR",
            "identifier": "Q10178",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U003",
            "identifier": "942938348KW1",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U002",
            "identifier": "802652",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Coop Koldewyn, LCSW
• Taffy Kosierowski
• Kris a Hill OD PC
• Kalli Kronmiller
• Steven K Kuwahara, RPH, PHD
• Ellie Kristine Lambert
• Elaine Lamoreaux
• Lilly Landikusic, LMFT
• Patrick Barde Lang, PA-C
• Cory A Larsen, RPH

• Clinical Social Worker in Midvale, UT
• Providers in Midvale, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.

Verify at the official NPI Registry.