Healthcare Provider Details

I. General information

NPI: 1902755952
Provider Name (Legal Business Name): TAYLOR L HENRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2026
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2081 BUSINESS CENTER DR STE 270
IRVINE CA
92612-1100
US

IV. Provider business mailing address

1054 S RIMWOOD DR
ANAHEIM CA
92807-5036
US

V. Phone/Fax

Practice location:
  • Phone: 657-500-1441
  • Fax:
Mailing address:
  • Phone: 657-500-1441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number16445
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: