Basic Information
| Provider Information | |||||||||
| NPI: | 1376054825 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TREMAYNE | ||||||||
| FirstName: | TAYLOR | ||||||||
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| Credential: | MA, CPC-I, CADC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 65 CALIENTE ST | ||||||||
| Address2: | APT#5 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89509 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 3500 LAKESIDE CT | ||||||||
| Address2: | STE 101 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757866880 | ||||||||
| FaxNumber: | 7757866899 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2017 | ||||||||
| LastUpdateDate: | 07/29/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 02113-I | NV | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YA0400X | 00818-C | NV | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YP2500X | CI5107 | NV | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.