Provider Demographics
NPI:1467740886
Name:TAYLOR, MARK ALLEN (APCC)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALLEN
Last Name:TAYLOR
Suffix:
Gender:
Credentials:APCC
Other - Prefix:DR
Other - First Name:MARK
Other - Middle Name:A
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APCC
Mailing Address - Street 1:201 N K ST
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-4005
Mailing Address - Country:US
Mailing Address - Phone:559-687-0929
Mailing Address - Fax:559-521-9310
Practice Address - Street 1:201 N K ST
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-4005
Practice Address - Country:US
Practice Address - Phone:559-687-0929
Practice Address - Fax:559-521-9310
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-19
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7166171M00000X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator