Provider Demographics
NPI:1215424262
Name:TAYLOR, DANIELLE DENISE
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:DENISE
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 1:25 ESSEX ST STE 122
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94105-3195
Mailing Address - Country:US
Mailing Address - Phone:415-767-3411
Mailing Address - Fax:415-977-0168
Practice Address - Street 1:25 ESSEX ST STE 122
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-3195
Practice Address - Country:US
Practice Address - Phone:415-767-3411
Practice Address - Fax:415-977-0168
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist