Provider Demographics
NPI:1043705775
Name:BRIGHT, TAYLOR (MS, ATC, OTC)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:MS, ATC, OTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2514 CLAIREMONT DR UNIT 306
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-6614
Mailing Address - Country:US
Mailing Address - Phone:916-221-8502
Mailing Address - Fax:
Practice Address - Street 1:4910 DIRECTORS PL STE 350
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3834
Practice Address - Country:US
Practice Address - Phone:588-571-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No246ZX2200XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherOrthopedic Assistant