Healthcare Provider Details

I. General information

NPI: 1952214116
Provider Name (Legal Business Name): TAYLOR MAKOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 OLD CREEK DR
ELK GROVE CA
95758-6150
US

IV. Provider business mailing address

5042 RESERVATION RD
PLACERVILLE CA
95667-9746
US

V. Phone/Fax

Practice location:
  • Phone: 916-684-7259
  • Fax:
Mailing address:
  • Phone: 805-260-4914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number6035
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: