Provider Demographics
NPI:1144056433
Name:RANKINS, TAYLOR ALEXIS
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ALEXIS
Last Name:RANKINS
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 1:20 CROLONA HTS
Mailing Address - Street 2:
Mailing Address - City:CROCKETT
Mailing Address - State:CA
Mailing Address - Zip Code:94525-1102
Mailing Address - Country:US
Mailing Address - Phone:707-654-5020
Mailing Address - Fax:
Practice Address - Street 1:1201 FILLMORE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-4110
Practice Address - Country:US
Practice Address - Phone:415-833-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA148382106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist