Provider Demographics
NPI:1467740886
Name:TAYLOR, MARK ALLEN (APCC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALLEN
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:APCC
Other - Prefix:DR
Other - First Name:MARK
Other - Middle Name:A
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APCC
Mailing Address - Street 1:201 N COURT ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-4918
Mailing Address - Country:US
Mailing Address - Phone:559-627-2046
Mailing Address - Fax:559-627-9079
Practice Address - Street 1:116 AGNES AVE
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-2838
Practice Address - Country:US
Practice Address - Phone:559-972-0511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7166171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator