Healthcare Provider Details

I. General information

NPI: 1770412991
Provider Name (Legal Business Name): TAYLOR CHAFFIN, NP, A PROFESSIONAL NURSING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25109 JEFFERSON AVE STE 325
MURRIETA CA
92562-8120
US

IV. Provider business mailing address

25109 JEFFERSON AVE STE 325
MURRIETA CA
92562-8120
US

V. Phone/Fax

Practice location:
  • Phone: 951-477-4934
  • Fax:
Mailing address:
  • Phone: 951-477-4934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TAYLOR MOANA CHAFFIN
Title or Position: NURSE PRACITIONER
Credential: PMHNP-BC
Phone: 951-216-5484