MEDICARE: TAYLOR JOHNSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251P0200X	Pediatric Physical Therapist		CA

General Provider Information

NPI Number	:	1184556664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR JOHNSON

Provider Business Mailing Address
First Line	:	2984 ELMWOOD ST
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91320-5535
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2984 ELMWOOD ST
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91320-5535
Country	:	US
Telephone Number	:	805-624-1542
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ TAYLOR JOHNSON ” Practice Location

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