MEDICARE: CHRISTA HELEN TAYLOR LCSW

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	171M00000X	Case Manager/Care Coordinator
2	1041C0700X	Clinical Social Worker	28663	CA

General Provider Information

NPI Number	:	1245305614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTA HELEN TAYLOR LCSW

Provider Business Mailing Address
First Line	:	816 KERN ST
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95928
Country	:	US
Telephone Number	:	530-899-2948
Fax Number	:

Provider Business Practice Location Address
First Line	:	560 COHASSET RD STE 175
Second Line	:	SUITE 175
City	:	CHICO
State	:	CA
Zip	:	95926-2212
Country	:	US
Telephone Number	:	530-891-2964
Fax Number	:	530-891-2809

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

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	12/19/2012

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