Healthcare Provider Details

I. General information

NPI: 1346197837
Provider Name (Legal Business Name): MARLENA TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 W SUNSET BLVD STE 400
LOS ANGELES CA
90026-3262
US

IV. Provider business mailing address

2968 W 7TH ST APT 521
LOS ANGELES CA
90005-4549
US

V. Phone/Fax

Practice location:
  • Phone: 315-878-9055
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC15202
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: