Provider Demographics
NPI:1033850532
Name:ZUNIGA SALAZAR, DANIELA ALEJANDRA (PA-C)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:ALEJANDRA
Last Name:ZUNIGA SALAZAR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8095 S SEGHINI DR APT H308
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-7829
Mailing Address - Country:US
Mailing Address - Phone:801-228-8441
Mailing Address - Fax:
Practice Address - Street 1:7410 S CREEK RD STE 100
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84093-6151
Practice Address - Country:US
Practice Address - Phone:801-816-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-06
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14155320-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant