Healthcare Provider Details

I. General information

NPI: 1558042986
Provider Name (Legal Business Name): TAYLOR BORIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2023
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1092 N EL CAMINO REAL
ENCINITAS CA
92024-1367
US

IV. Provider business mailing address

10790 RANCHO BERNARDO RD
SAN DIEGO CA
92127-5705
US

V. Phone/Fax

Practice location:
  • Phone: 760-633-6507
  • Fax:
Mailing address:
  • Phone: 760-633-6507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number23499
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: