Healthcare Provider Details

I. General information

NPI: 1346926953
Provider Name (Legal Business Name): MEGHAN MARIE TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 TELEGRAPH RD
VENTURA CA
93003-4113
US

IV. Provider business mailing address

5225 TELEGRAPH RD
VENTURA CA
93003-4113
US

V. Phone/Fax

Practice location:
  • Phone: 805-765-6495
  • Fax:
Mailing address:
  • Phone: 805-798-4893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number287784
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: