Individual
MR. JACOB LEE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13716 MONTEREY AVE, BALDWIN PARK, CA 91706-4057
(626) 485-6390
Mailing address
13716 MONTEREY AVE, BALDWIN PARK, CA 91706-4057
(626) 485-6390
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
34166
CA
Other
Enumeration date
08/20/2008
Last updated
08/20/2008
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