Healthcare Provider Details

I. General information

NPI: 1598689879
Provider Name (Legal Business Name): MRS. STEPHANIE MARIE TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 DISTRICT CENTER DR
PALM SPRINGS CA
92264-3626
US

IV. Provider business mailing address

1272 PARK AVE
SAN JACINTO CA
92583-5723
US

V. Phone/Fax

Practice location:
  • Phone: 951-282-5488
  • Fax:
Mailing address:
  • Phone: 951-282-5488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSPA1061
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: