Healthcare Provider Details

I. General information

NPI: 1275445363
Provider Name (Legal Business Name): LAUREN ELYSE TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 S FAIR OAKS AVE STE 217218
PASADENA CA
91105-2010
US

IV. Provider business mailing address

4117 COLBATH AVE
SHERMAN OAKS CA
91423-4207
US

V. Phone/Fax

Practice location:
  • Phone: 626-681-3283
  • Fax:
Mailing address:
  • Phone: 661-221-1144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT164555
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: