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NPI Code Detail

MEDICARE: TAYLOR JAY WILSON

MEDICARE: TAYLOR JAY WILSON
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
1106H00000XMarriage & Family TherapistAMFT161373CA

General Provider Information

NPI Number : 1851235469
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR JAY WILSON
Provider Business Mailing Address
First Line : 2116 ARLINGTON AVE STE 100
Second Line :
City : LOS ANGELES
State : CA
Zip : 90018-1300
Country : US
Telephone Number : 323-334-9000
Fax Number :
Provider Business Practice Location Address
First Line : 2116 ARLINGTON AVE STE 100
Second Line :
City : LOS ANGELES
State : CA
Zip : 90018-1300
Country : US
Telephone Number : 323-334-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2026
Last Update Date : 04/15/2026

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Directions to “ TAYLOR JAY WILSON ” Practice Location

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