MEDICARE: TAYLOR COLVEY CFNC, NBC-HWC

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	171400000X	Health & Wellness Coach	A-3254046	CA

General Provider Information

NPI Number	:	1497538557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR COLVEY CFNC, NBC-HWC

Provider Business Mailing Address
First Line	:	PO BOX 7372
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92167-0372
Country	:	US
Telephone Number	:	858-880-5820
Fax Number	:

Provider Business Practice Location Address
First Line	:	253 S HIGHWAY 101 STE A
Second Line	:
City	:	SOLANA BEACH
State	:	CA
Zip	:	92075-1864
Country	:	US
Telephone Number	:	858-880-5820
Fax Number	:

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

Provider Enumeration Date	:	08/14/2023
Last Update Date	:	08/14/2023

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