Healthcare Provider Details

I. General information

NPI: 1528040029
Provider Name (Legal Business Name): THERESA M TAYLOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 03/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 N MAIN ST
SALINAS CA
93906-3912
US

IV. Provider business mailing address

919 N MAIN ST
SALINAS CA
93906-3912
US

V. Phone/Fax

Practice location:
  • Phone: 831-754-0833
  • Fax: 831-754-4358
Mailing address:
  • Phone: 831-754-0833
  • Fax: 831-754-4358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ANNE LASSON
Title or Position: VICE PRESIDENT
Credential:
Phone: 408-570-0510