Healthcare Provider Details

I. General information

NPI: 1760345854
Provider Name (Legal Business Name): PATRICIA TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 E KELSO ST
INGLEWOOD CA
90301-2703
US

IV. Provider business mailing address

340 E KELSO ST
INGLEWOOD CA
90301-2703
US

V. Phone/Fax

Practice location:
  • Phone: 310-800-1568
  • Fax:
Mailing address:
  • Phone: 310-800-1568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: