Healthcare Provider Details

I. General information

NPI: 1912229097
Provider Name (Legal Business Name): TAYLOR BEEBE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2010
Last Update Date: 02/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 30TH ST
OAKLAND CA
94609-3310
US

IV. Provider business mailing address

5674 STONERIDGE DR
PLEASANTON CA
94588-8500
US

V. Phone/Fax

Practice location:
  • Phone: 510-675-0600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: