Healthcare Provider Details

I. General information

NPI: 1609374727
Provider Name (Legal Business Name): TAYLOR CRAWFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2018
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

244 W 300 S STE 214
PROVO UT
84601-4369
US

IV. Provider business mailing address

956 BLACKSTONE DR
SAN MARCOS CA
92078-1414
US

V. Phone/Fax

Practice location:
  • Phone: 801-457-6488
  • Fax: 801-457-6489
Mailing address:
  • Phone: 925-876-8902
  • Fax: 801-457-2488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-41878
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number14229679-2506
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: