| Penny Brooke Jameson, Ph. D., P.c. | |
|
1801 S 2600 E Salt Lake City UT 84108-3331 | |
| (801) 350-0118 | |
| Not Available |
| Full Name | Penny Brooke Jameson, Ph. D., P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 1801 S 2600 E, Salt Lake City, Utah |
| Authorized Official Name and Position | Penny Brooke Jameson (PRESIDENT) |
| Authorized Official Contact | 8013500118 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Penny Brooke Jameson, Ph. D., P.c. 1801 S 2600 E Salt Lake City UT 84108-3331 Ph: (801) 350-0118 | Penny Brooke Jameson, Ph. D., P.c. 1801 S 2600 E Salt Lake City UT 84108-3331 Ph: (801) 350-0118 |
| NPI Number | 1982038238 |
|---|---|
| Provider Enumeration Date | 08/22/2013 |
| Last Update Date | 08/22/2013 |
| Medicare PECOS PAC ID | 8224269386 |
|---|---|
| Medicare Enrollment ID | O20140402002328 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982038238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 277000-2501 (Utah) | Primary |
| Provider Name | Penny B Jameson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134125776 PECOS PAC ID: 8325032642 Enrollment ID: I20040412000133 |
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