Healthcare Provider Details

I. General information

NPI: 1720915259
Provider Name (Legal Business Name): MONIQUE TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 KAIBAB AVE
BAKERSFIELD CA
93306-1937
US

IV. Provider business mailing address

2600 KAIBAB AVE
BAKERSFIELD CA
93306-1937
US

V. Phone/Fax

Practice location:
  • Phone: 661-304-6995
  • Fax:
Mailing address:
  • Phone: 661-304-6995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number87413
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: