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NPI Code Detail

MEDICARE: RAVEN TAYLOR

MEDICARE: RAVEN TAYLOR
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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1306600200
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAVEN TAYLOR
Provider Business Mailing Address
First Line : PO BOX 2077
Second Line :
City : UKIAH
State : CA
Zip : 95482-2077
Country : US
Telephone Number : 707-467-2010
Fax Number :
Provider Business Practice Location Address
First Line : 2143 F ST
Second Line :
City : EUREKA
State : CA
Zip : 95501-3738
Country : US
Telephone Number : 707-798-1895
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2024
Last Update Date : 02/12/2024

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Directions to “ RAVEN TAYLOR ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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