Provider Demographics
NPI:1538439575
Name:BERNINGER, TAYLOR JANE (MS, MA, MED, LCGC)
Entity type:Individual
Prefix:MS
First Name:TAYLOR
Middle Name:JANE
Last Name:BERNINGER
Suffix:
Gender:F
Credentials:MS, MA, MED, LCGC
Other - Prefix:MS
Other - First Name:TAYLOR
Other - Middle Name:JANE
Other - Last Name:SALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4910 DIRECTORS PL
Mailing Address - Street 2:STE 200
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3811
Mailing Address - Country:US
Mailing Address - Phone:858-249-5408
Mailing Address - Fax:
Practice Address - Street 1:4910 DIRECTORS PL
Practice Address - Street 2:STE 200
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3811
Practice Address - Country:US
Practice Address - Phone:858-249-5408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-06
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGC000288170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS