Healthcare Provider Details

I. General information

NPI: 1962329144
Provider Name (Legal Business Name): TAYLOR ALISE CLAIBORNE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4880 MARKET ST
VENTURA CA
93003-7783
US

IV. Provider business mailing address

PO BOX 50508
OXNARD CA
93031-0508
US

V. Phone/Fax

Practice location:
  • Phone: 866-600-7598
  • Fax:
Mailing address:
  • Phone: 805-512-0375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: