MEDICARE: DIARRA 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	103TS0200X	School Psychologist	220108456	CA

General Provider Information

NPI Number	:	1710829411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIARRA TAYLOR

Provider Business Mailing Address
First Line	:	4820 CLAIREMONT MESA BLVD APT 24
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-2104
Country	:	US
Telephone Number	:	760-291-3200
Fax Number	:

Provider Business Practice Location Address
First Line	:	1690 WANDERING RD
Second Line	:
City	:	ENCINITAS
State	:	CA
Zip	:	92024-2417
Country	:	US
Telephone Number	:	760-944-4329
Fax Number	:

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

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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Directions to “ DIARRA TAYLOR ” Practice Location

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