Provider Demographics
NPI:1689784324
Name:TAYLOR, KATHERINE RENEE (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:RENEE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2456 WEST BAYSHORE ROAD
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303
Mailing Address - Country:US
Mailing Address - Phone:650-387-5097
Mailing Address - Fax:
Practice Address - Street 1:3801 MIRANDA AVE
Practice Address - Street 2:C/O AUDIOLOGY/SPEECH PATHOLOGY (126)
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304
Practice Address - Country:US
Practice Address - Phone:650-493-5000
Practice Address - Fax:650-849-0516
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 12563235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist