SAMUEL IRVING TAYLOR III (NPI# 1720218266) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720218266 |
| Entity Type | Individual |
| Full Name | SAMUEL IRVING TAYLOR III |
| Practice Address |
581 63rd St Oakland CA 94609-1244 |
| Practice Telephone | 4154104975 |
| Mailing Telephone | 4154104975 |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2009-07-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295240612 | Samuel Taylor | Counselor | 77 E Weldon Ave Ste 210, Phoenix, AZ 85012-2380 | 2017-12-07 |
| 1609288240 | Samuel Thomas Le Roy Taylor | Social Worker | 4500 Cherry Creek Drive S., Suit 940, Denver, CO 80246 | 2014-06-02 |
| 1477683787 | Samuel E Taylor | Dentist | 9795 Ravenna Rd, Twinsburg, OH 44087 | 2007-03-06 |
| 1164436788 | Samuel Taylor | Obstetrics & Gynecology | 677 Church St Ne # 125, Marietta, GA 30060 | 2006-07-28 |
| 1568491017 | Samuel Wayne Taylor Jr. | Ophthalmology | 500 Hargrove Rd E, Tuscaloosa, AL 35401-3751 | 2006-06-30 |
| 1326657669 | Samuel Marcus Taylor | Peer Specialist | 1501 Ne 11th St, Oklahoma City, OK 73117-2605 | 2020-07-22 |
| 1073051884 | Samuel Taylor | Nurse Anesthetist, Certified Registered | 1720 Louisiana Blvd Ne, Suite 401, Albuquerque, NM 87110-7022 | 2017-02-01 |
| 1710357025 | Samuel Paul Taylor | Counselor | 285 Vanderbilt Ave, Staten Island, NY 10304-2525 | 2015-09-29 |
| 1578963245 | Samuel Taylor | Dentist | 2410 Sampson St Bldg 237, Great Lakes, IL 60088-2942 | 2014-08-29 |
| 1922393594 | Samuel H. Taylor | Psychologist | 4641 Fulton Dr Nw, Canton, OH 44718-2384 | 2011-06-12 |
| Street Address |
581 63RD ST |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-1244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477882702 | Lavendor Dangerfield | Counselor | 581 63rd St, Oakland, CA 94609-1244 | 2009-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
| 1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
| 1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
| 1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
| 1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
| 1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
| 1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
| 1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
| Find all providers in zip 94609 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820499 | Catholic Charities of The Diocese of Oakland | Residential Treatment Facility, Emotionally Disturbed Children | 3700 Dorisa Ave, Oakland, CA 94605-4941 | 2020-10-27 |
| 1548877657 | T & T House of Champions | Residential Treatment Facility, Emotionally Disturbed Children | 2115 High St, Oakland, CA 94601-4335 | 2020-09-23 |
| 1699389452 | Millie's Youth Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2512 Havenscourt Blvd, Oakland, CA 94605-1935 | 2020-08-31 |
| 1093345589 | Quest Programs, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 5751 Adeline St, Oakland, CA 94608-2815 | 2020-01-23 |
| 1801088059 | Lincoln Child Center | Residential Treatment Facility, Emotionally Disturbed Children | 3524 Foothill Blvd Apt 9, Oakland, CA 94601-3644 | 2007-08-13 |
| 1952431462 | Tracy Scott-jefferson | Residential Treatment Facility, Emotionally Disturbed Children | 824 12th St, Oakland, CA 94607-3232 | 2007-03-06 |
| 1326173568 | Seneca Center | Residential Treatment Facility, Emotionally Disturbed Children | 2701 Ivy Dr, Apt. C, Oakland, CA 94606-2172 | 2007-02-21 |
| 1487187951 | Greater New Beginnings Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1625 Filbert St, Oakland, CA 94607-2890 | 2017-04-11 |
| 1336554062 | Refuge | Residential Treatment Facility, Emotionally Disturbed Children | 4321 Tompkins Ave, Oakland, CA 94619-2820 | 2014-06-20 |
| 1932343951 | Refuge Inc | Residential Treatment Facility, Emotionally Disturbed Children | 3906 Loma Vista Ave, Oakland, CA 94619-1426 | 2009-04-21 |
| Find all providers in OAKLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.