Healthcare Provider Details

I. General information

NPI: 1831039759
Provider Name (Legal Business Name): JOY IRENE TAYLOR RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4411 GEARY BLVD STE 100
SAN FRANCISCO CA
94118-3044
US

IV. Provider business mailing address

4411 GEARY BLVD STE 100
SAN FRANCISCO CA
94118-3044
US

V. Phone/Fax

Practice location:
  • Phone: 628-285-3963
  • Fax:
Mailing address:
  • Phone: 628-285-3963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number730576
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: