Provider Demographics
NPI:1043845746
Name:CARMONA, JAYSON (MS, LMFT)
Entity type:Individual
Prefix:
First Name:JAYSON
Middle Name:
Last Name:CARMONA
Suffix:
Gender:M
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 W SERGEANT COURT DR STE 201
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:UT
Mailing Address - Zip Code:84045-5809
Mailing Address - Country:US
Mailing Address - Phone:801-341-1919
Mailing Address - Fax:
Practice Address - Street 1:1674 E DOWNWATER ST
Practice Address - Street 2:
Practice Address - City:EAGLE MOUNTAIN
Practice Address - State:UT
Practice Address - Zip Code:84005-5123
Practice Address - Country:US
Practice Address - Phone:385-325-1779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-03
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT105349443904106H00000X
UT10534944-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist