Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1013063379 |
---|---|
Provider Name | Ms. Keri Dawn Taylor |
First Address | Santa Ana, CA 92706 |
Second Address | Santa Ana, CA 92706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 22/10/2009 |