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General NPI Number Information
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NPI Number | 1679252274
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Entity Type | Individual
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Provider Name | ADRIENNE ALYSSA TAYLOR
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Gender | Female
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 261 D ST
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City | BRAWLEY
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State | CA
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Zip | 92227-1912
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Country | US
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Telephone | 760-344-2330
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Fax |
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Provider Business Mailing Address
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Address Line | 480 ALTA RD
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City | SAN DIEGO
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State | CA
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Zip | 92179-0001
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Country | US
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Telephone | 760-996-8220
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 13640
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 120692
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 120692
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License Number State | CA
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