Provider Demographics
NPI:1154565513
Name:TAYLOR, STEVE (BCBA)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95361-2838
Mailing Address - Country:US
Mailing Address - Phone:209-847-5668
Mailing Address - Fax:209-847-5668
Practice Address - Street 1:1335 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:CA
Practice Address - Zip Code:95361-2838
Practice Address - Country:US
Practice Address - Phone:209-847-5668
Practice Address - Fax:209-847-5668
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst