Provider Demographics
NPI:1457429912
Name:TAYLOR, BONNIE CLAIRE (MD)
Entity Type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:CLAIRE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 3RD ST STE 400
Mailing Address - Street 2:FOSTER CARE MENTAL HEALTH
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94124-1409
Mailing Address - Country:US
Mailing Address - Phone:415-970-3850
Mailing Address - Fax:415-970-3813
Practice Address - Street 1:3801 3RD ST STE 400
Practice Address - Street 2:FOSTER CARE MENTAL HEALTH
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94124-1409
Practice Address - Country:US
Practice Address - Phone:415-970-3850
Practice Address - Fax:415-970-3813
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG668912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G668910Medicaid
CA00G668910Medicaid