Healthcare Provider Details

I. General information

NPI: 1174935258
Provider Name (Legal Business Name): ROBIN TAYLOR-BOYD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2014
Last Update Date: 05/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 REDWOOD ST 247
VALLEJO CA
94590-2985
US

IV. Provider business mailing address

445 REDWOOD ST 247
VALLEJO CA
94590-2985
US

V. Phone/Fax

Practice location:
  • Phone: 707-980-7703
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number507361
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number507361
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number507361
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number507361
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: