Provider Demographics
NPI:1336025212
Name:LEAVITT, SARAH JANE
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:LEAVITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8876 S STONE SPRING CIR
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84081-2224
Mailing Address - Country:US
Mailing Address - Phone:801-833-3811
Mailing Address - Fax:
Practice Address - Street 1:5689 S REDWOOD RD UNIT 27
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84123-5499
Practice Address - Country:US
Practice Address - Phone:801-266-2485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program