Provider Demographics
NPI:1215178702
Name:ADANRITAYLOR, TITILOLA HARRIET (RN)
Entity Type:Individual
Prefix:MRS
First Name:TITILOLA
Middle Name:HARRIET
Last Name:ADANRITAYLOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 WALLY WAY
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-3684
Mailing Address - Country:US
Mailing Address - Phone:619-760-6868
Mailing Address - Fax:
Practice Address - Street 1:1630 WALLY WAY
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-3684
Practice Address - Country:US
Practice Address - Phone:619-760-6868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA643553101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health