Provider Demographics
NPI:1639991664
Name:CARDENAS, SARAH JEAN (BCBA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JEAN
Last Name:CARDENAS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3212 S 2000 E
Mailing Address - Street 2:
Mailing Address - City:MILLCREEK
Mailing Address - State:UT
Mailing Address - Zip Code:84109-2602
Mailing Address - Country:US
Mailing Address - Phone:801-842-6111
Mailing Address - Fax:
Practice Address - Street 1:2825 E COTTONWOOD PKWY STE 500
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-7060
Practice Address - Country:US
Practice Address - Phone:801-919-8997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14190035-2506103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst