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General NPI Number Information
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NPI Number | 1700254463
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Entity Type | Individual
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Provider Name | BIANCA KATALINA CRYSTAL TAYLOR
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Gender | Female
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Dates
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Enumeration Date | 09/10/2015
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 310 JAMES WAY STE 150
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City | PISMO BEACH
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State | CA
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Zip | 93449-2877
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Country | US
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Telephone | 805-206-3354
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Fax |
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Provider Business Mailing Address
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Address Line | 310 JAMES WAY STE 150
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City | PISMO BEACH
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State | CA
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Zip | 93449-2877
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Country | US
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Telephone | 805-206-3354
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW96135
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License Number State | CA
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