Provider Demographics
NPI:1497538557
Name:COLVEY, TAYLOR (CFNC, NBC-HWC)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:COLVEY
Suffix:
Gender:F
Credentials:CFNC, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7372
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92167-0372
Mailing Address - Country:US
Mailing Address - Phone:858-880-5820
Mailing Address - Fax:
Practice Address - Street 1:253 S HIGHWAY 101 STE A
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1864
Practice Address - Country:US
Practice Address - Phone:858-880-5820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA-3254046171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach