Dr. Jaime Bercuson, M.A., Psy.D.
Psychologist, Clinical in Park City, UT. Individual provider (NPI-1).
NPI number1932332012
StatusActive
Last updated in NPPESNov 10, 2020
Details
- NPI
- 1932332012
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jaime Bercuson
- Credential
- M.A., Psy.D.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 24, 2009
- Certification date
- Nov 10, 2020
- Last updated
- Nov 10, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 10389140-2501 | UT | Yes |
| 103TC0700X | Psychologist, Clinical | PSY26093 | CA | |
| 103TC0700X | Psychologist, Clinical | PY8969 | FL |
Practice location
1389 Center Dr Ste 200Park City, UT 84098-7660
Phone 727-451-9223
Mailing address
1389 Center Dr Ste 200Park City, UT 84098-7660
Phone 727-451-9223
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