Provider Demographics
NPI:1609942432
Name:TAYLOR, DIANA LEE (RNP, PHD)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:LEE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RNP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 DAVIS ST
Mailing Address - Street 2:APT. 13
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-1946
Mailing Address - Country:US
Mailing Address - Phone:415-834-1363
Mailing Address - Fax:415-834-9549
Practice Address - Street 1:2166 HAYES ST
Practice Address - Street 2:SUITE 104
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1033
Practice Address - Country:US
Practice Address - Phone:415-379-7800
Practice Address - Fax:415-379-7804
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA253585363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health