Healthcare Provider Details

I. General information

NPI: 1043988926
Provider Name (Legal Business Name): TAYLOR WESTHOLM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAYLOR WESTHOLM

II. Dates (important events)

Enumeration Date: 09/03/2021
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3916 LIMBER PINE RD
FALLBROOK CA
92028-8052
US

IV. Provider business mailing address

3916 LIMBER PINE RD
FALLBROOK CA
92028-8052
US

V. Phone/Fax

Practice location:
  • Phone: 760-415-2530
  • Fax:
Mailing address:
  • Phone: 760-415-2530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number20352
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: