Provider Demographics
NPI:1396084935
Name:PEARCE, TAYLOR RENEE (MA, BCBA)
Entity type:Individual
Prefix:MS
First Name:TAYLOR
Middle Name:RENEE
Last Name:PEARCE
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:RENEE
Other - Last Name:MENDOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, BCBA
Mailing Address - Street 1:3702 RUFFIN RD
Mailing Address - Street 2:100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1893
Mailing Address - Country:US
Mailing Address - Phone:619-297-4300
Mailing Address - Fax:619-297-4400
Practice Address - Street 1:3702 RUFFIN RD
Practice Address - Street 2:100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1893
Practice Address - Country:US
Practice Address - Phone:619-297-4300
Practice Address - Fax:619-297-4400
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-12-12133103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst