Provider Demographics
NPI:1154155471
Name:TAYLOR, DENISE S (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:S
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7733 LUCIA CT
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-8126
Mailing Address - Country:US
Mailing Address - Phone:858-621-3396
Mailing Address - Fax:
Practice Address - Street 1:7733 LUCIA CT
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-8126
Practice Address - Country:US
Practice Address - Phone:858-621-3396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65162400163WM0102X
CA95162400163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn