Provider Demographics
NPI:1609677004
Name:JENSEN, JOSHUA RICHARD (DO)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:RICHARD
Last Name:JENSEN
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1763 W LITTLE WILLOW CV
Mailing Address - Street 2:
Mailing Address - City:MAPLETON
Mailing Address - State:UT
Mailing Address - Zip Code:84664-5628
Mailing Address - Country:US
Mailing Address - Phone:801-367-5742
Mailing Address - Fax:
Practice Address - Street 1:1763 W LITTLE WILLOW CV
Practice Address - Street 2:
Practice Address - City:MAPLETON
Practice Address - State:UT
Practice Address - Zip Code:84664-5628
Practice Address - Country:US
Practice Address - Phone:801-367-5742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program