Healthcare Provider Details

I. General information

NPI: 1265360648
Provider Name (Legal Business Name): VERNA LOIS TAIT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 W B ST FL 4
SAN DIEGO CA
92101-3537
US

IV. Provider business mailing address

6677 SANTA MONICA BLVD APT 2503
LOS ANGELES CA
90038-1497
US

V. Phone/Fax

Practice location:
  • Phone: 858-222-4893
  • Fax:
Mailing address:
  • Phone: 510-750-0345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number146940
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: