Healthcare Provider Details

I. General information

NPI: 1912291907
Provider Name (Legal Business Name): JULIE T TAYLOR R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2011
Last Update Date: 06/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10531 4S COMMONS DR #500
SAN DIEGO CA
92127-3517
US

IV. Provider business mailing address

10531 4S COMMONS DR #500
SAN DIEGO CA
92127-3517
US

V. Phone/Fax

Practice location:
  • Phone: 858-943-1090
  • Fax: 858-487-3173
Mailing address:
  • Phone: 858-943-1090
  • Fax: 858-487-3173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number506614
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number506614
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: