Healthcare Provider Details

I. General information

NPI: 1245530401
Provider Name (Legal Business Name): CHRISTINE BRINN TAYLOR LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE LEE BRINN

II. Dates (important events)

Enumeration Date: 10/21/2010
Last Update Date: 02/12/2022
Certification Date: 02/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1540 E. COLORADO ST.
GLENDALE CA
91205
US

IV. Provider business mailing address

1540 E. COLORADO ST.
GLENDALE CA
91205
US

V. Phone/Fax

Practice location:
  • Phone: 818-244-7257
  • Fax: 213-380-8923
Mailing address:
  • Phone: 818-244-7257
  • Fax: 213-380-8923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF67846
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT91184
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: