Basic Information
| Provider Information | |||||||||
| NPI: | 1982174942 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TAULBEE | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | |||||||||
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| Credential: | ASW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3960 WALNUT DR | ||||||||
| Address2: | |||||||||
| City: | EUREKA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 955038938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7072688722 | ||||||||
| FaxNumber: | 7072680218 | ||||||||
| Practice Location | |||||||||
| Address1: | 3960 WALNUT DR | ||||||||
| Address2: | |||||||||
| City: | EUREKA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7072688722 | ||||||||
| FaxNumber: | 7072680218 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2018 | ||||||||
| LastUpdateDate: | 06/09/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 77712 | CA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101Y00000X | 77712 | N | Behavioral Health & Social Service Providers | Counselor | 1041C0700X | 77712 | CA | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | 101829 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.