Individual provider · Type 1 NPI

Koko Tiatia

Student in an Organized Health Care Education/Training Program · Eagle Mountain, UT

NPI number 1790699189 Active

Practice location

4066 E Sunbury Ln
Eagle Mountain, UT 84005-6333

Call (801) 361-8399 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000X13389615-3102 (UT)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1790699189

Koko Tiatia's National Provider Identifier is 1790699189, issued on Oct 1, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Eagle Mountain, UT. The record was last updated on Oct 1, 2026.