MEDICARE: PATRICIA WANSLEY TAYLOR, LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center	85355	CA
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center	85355	CA
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	85355	CA

General Provider Information

NPI Number	:	1417484312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATRICIA WANSLEY TAYLOR, LMFT

Provider Business Mailing Address
First Line	:	2204 S EL CAMINO REAL STE 205
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6389
Country	:	US
Telephone Number	:	760-585-5680
Fax Number	:	844-373-1890

Provider Business Practice Location Address
First Line	:	2204 S EL CAMINO REAL STE 205
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6389
Country	:	US
Telephone Number	:	760-585-5680
Fax Number	:	844-373-1890

Authorized Official
Title or Position	:	LFMT
Name	:	PATRICIA TAYLOR
Credential	:
Telephone Number	:	760-585-5680

Provider Enumeration Date	:	05/23/2017
Last Update Date	:	07/21/2022

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