Healthcare Provider Details

I. General information

NPI: 1992424717
Provider Name (Legal Business Name): DONYELL TAYLNN FACTORY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 10/06/2023
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 H ST
BAKERSFIELD CA
93301-1913
US

IV. Provider business mailing address

2821 H ST
BAKERSFIELD CA
93301-1913
US

V. Phone/Fax

Practice location:
  • Phone: 661-546-6332
  • Fax:
Mailing address:
  • Phone: 661-371-3360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: