Provider Demographics
NPI:1700493327
Name:TAYLOR, NATALIE N
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:N
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5515 SAN JUAN WAY
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-7732
Mailing Address - Country:US
Mailing Address - Phone:925-989-3609
Mailing Address - Fax:
Practice Address - Street 1:620 E ANGELA ST
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-7414
Practice Address - Country:US
Practice Address - Phone:925-918-3585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst