Provider Demographics
NPI:1629278304
Name:TAYLOR, DONALD JOHN (NP)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:JOHN
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2523 W 7TH ST
Mailing Address - Street 2:ENKI HEALTH & RESEARCH SYSTEMS, INC. PICO UNION
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-3801
Mailing Address - Country:US
Mailing Address - Phone:626-757-4974
Mailing Address - Fax:
Practice Address - Street 1:2523 W 7TH ST
Practice Address - Street 2:ENKI HEALTH & RESEARCH SYSTEMS, INC. PICO UNION
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3801
Practice Address - Country:US
Practice Address - Phone:626-757-4974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA532792225400000X, 363LP0808X
CARN 532792163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health