Healthcare Provider Details

I. General information

NPI: 1194653147
Provider Name (Legal Business Name): HEATHER TAYLOR-LIVELY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HEATHER TAYLOR

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 STATE ST UNIT B
SANTA BARBARA CA
93101-3301
US

IV. Provider business mailing address

14320 VENTURA BLVD # 816
SHERMAN OAKS CA
91423-2717
US

V. Phone/Fax

Practice location:
  • Phone: 805-620-7096
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: