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Individual

LARISA TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1661 SOQUEL DR, SUITE A, SANTA CRUZ, CA 95065-1709
(831) 476-7676
(831) 476-4824
Mailing address
5610 SCOTTS VALLEY DR, B221, SCOTTS VALLEY, CA 95066-3473

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
A80736
CA
207V00000X
Obstetrics & Gynecology Physician
Primary
BT8050255
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G358690
CA
01
BT8050255
LIC
Enumeration date
11/30/2006
Last updated
03/07/2023
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