Healthcare Provider Details

I. General information

NPI: 1306609557
Provider Name (Legal Business Name): TAYLOR RENO DACM, L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2024
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1527 BAKER ST
SAN FRANCISCO CA
94115-2908
US

IV. Provider business mailing address

883 43RD AVE
SAN FRANCISCO CA
94121-3303
US

V. Phone/Fax

Practice location:
  • Phone: 415-570-8794
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number19953
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: