Provider Demographics
NPI:1912798000
Name:TAYLOR, LISA M (PCD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 IWANUMA DR
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3561
Mailing Address - Country:US
Mailing Address - Phone:707-968-7552
Mailing Address - Fax:
Practice Address - Street 1:19 IWANUMA DR
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3561
Practice Address - Country:US
Practice Address - Phone:707-968-7552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-16
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula