Healthcare Provider Details

I. General information

NPI: 1568973469
Provider Name (Legal Business Name): MRS. TAYLER KINA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TAYLER EPPLER

II. Dates (important events)

Enumeration Date: 10/18/2017
Last Update Date: 03/23/2021
Certification Date: 03/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 BERN CT STE 130
SAN JOSE CA
95112-1242
US

IV. Provider business mailing address

151 BUSINESS CENTER LOOP STE A
KALISPELL MT
59901-8560
US

V. Phone/Fax

Practice location:
  • Phone: 408-437-8864
  • Fax:
Mailing address:
  • Phone: 808-650-0926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: