Provider Demographics
NPI:1558045880
Name:TAYLOR, ABBY CHRISTINE
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:CHRISTINE
Last Name:TAYLOR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8912 VOLUNTEER LANE SACRAMENTO
Mailing Address - Street 2:
Mailing Address - City:SACRAMENT0
Mailing Address - State:CA
Mailing Address - Zip Code:95826
Mailing Address - Country:US
Mailing Address - Phone:916-809-0447
Mailing Address - Fax:
Practice Address - Street 1:8912 VOLUNTEER LANE SACRAMENTO
Practice Address - Street 2:
Practice Address - City:SACRAMENT0
Practice Address - State:CA
Practice Address - Zip Code:95826
Practice Address - Country:US
Practice Address - Phone:916-809-0447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT196840409171M00000X
172V00000X, 175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker