Provider Demographics
NPI:1174195416
Name:TAIRA, MEGAN MARIE
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:TAIRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7613 WESTFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1239
Mailing Address - Country:US
Mailing Address - Phone:661-699-4380
Mailing Address - Fax:
Practice Address - Street 1:7613 WESTFIELD RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1239
Practice Address - Country:US
Practice Address - Phone:661-699-4380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-15
Last Update Date:2024-12-10
Deactivation Date:2023-02-23
Deactivation Code:
Reactivation Date:2024-12-10
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst