Provider Demographics
NPI:1366503484
Name:TAYLOR-ADAMS, TONYA R (MPT)
Entity Type:Individual
Prefix:MS
First Name:TONYA
Middle Name:R
Last Name:TAYLOR-ADAMS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:RENEE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30311 SILVER RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-7323
Mailing Address - Country:US
Mailing Address - Phone:901-282-5783
Mailing Address - Fax:
Practice Address - Street 1:30311 SILVER RIDGE CT
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-7323
Practice Address - Country:US
Practice Address - Phone:901-282-5783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41482225100000X
TN6659225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA41482OtherPHYSICAL THERAPY LICENSE
TN6659OtherPHYSICAL THERAPY LICENSE