MEDICARE: RICHARD THOMAS TAYLOR

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	1041C0700X	Clinical Social Worker	ASW137144	CA
2	171M00000X	Case Manager/Care Coordinator
3	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1679189047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD THOMAS TAYLOR

Provider Business Mailing Address
First Line	:	825 9TH ST
Second Line	:
City	:	MARYSVILLE
State	:	CA
Zip	:	95901-5265
Country	:	US
Telephone Number	:	916-676-0488
Fax Number	:

Provider Business Practice Location Address
First Line	:	825 9TH ST
Second Line	:
City	:	MARYSVILLE
State	:	CA
Zip	:	95901-5265
Country	:	US
Telephone Number	:	916-676-0488
Fax Number	:

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

Provider Enumeration Date	:	09/21/2020
Last Update Date	:	02/20/2026

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