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NPI Code Detail

MEDICARE: MARJORIE TAYAG LACAP BCBA

MEDICARE: MARJORIE TAYAG LACAP BCBA
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
1103K00000XBehavior Analyst1-24-74576CA

General Provider Information

NPI Number : 1942793880
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARJORIE TAYAG LACAP BCBA
Provider Business Mailing Address
First Line : 1536 9TH ST APT G
Second Line :
City : ALAMEDA
State : CA
Zip : 94501-3401
Country : US
Telephone Number : 650-534-8569
Fax Number :
Provider Business Practice Location Address
First Line : 1301 REDWOOD WAY STE 210
Second Line :
City : PETALUMA
State : CA
Zip : 94954-1134
Country : US
Telephone Number : 707-806-9921
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2018
Last Update Date : 04/23/2026

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