Healthcare Provider Details

I. General information

NPI: 1457291460
Provider Name (Legal Business Name): RACHEL ANN TAYLOR
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2629 FOOTHILL BLVD # 457
LA CRESCENTA CA
91214-3511
US

IV. Provider business mailing address

2629 FOOTHILL BLVD # 457
LA CRESCENTA CA
91214-3511
US

V. Phone/Fax

Practice location:
  • Phone: 424-281-9781
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number158973
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: