Provider Demographics
NPI:1104136910
Name:TAYLOR, AUBREE CHRISTENE FAE
Entity type:Individual
Prefix:
First Name:AUBREE
Middle Name:CHRISTENE FAE
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:PO BOX 265
Mailing Address - Street 2:
Mailing Address - City:LOYALTON
Mailing Address - State:CA
Mailing Address - Zip Code:96118-0265
Mailing Address - Country:US
Mailing Address - Phone:530-993-6765
Mailing Address - Fax:
Practice Address - Street 1:704 MILL STREET
Practice Address - Street 2:
Practice Address - City:LOYALTON
Practice Address - State:CA
Practice Address - Zip Code:96118
Practice Address - Country:US
Practice Address - Phone:530-993-6765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional