MEDICARE: TAYLOR ROBERT LOWREY BIVIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1376498832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR ROBERT LOWREY BIVIN

Provider Business Mailing Address
First Line	:	1953 DEVAUL RANCH DR
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93405-7433
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8834 MORRO RD
Second Line	:
City	:	ATASCADERO
State	:	CA
Zip	:	93422-3953
Country	:	US
Telephone Number	:	805-466-7827
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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