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Individual

TAYLOR HEUSCHELE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3132 JEFFERSON ST, SAN DIEGO, CA 92110-4421
(619) 683-3100
Mailing address
4219 DEL MONTE AVE, SAN DIEGO, CA 92107-3643
(619) 887-1644

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-AJVWSR
CA
373H00000X
Day Training/Habilitation Specialist
CA

Other

Enumeration date
08/21/2024
Last updated
03/06/2026
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