Healthcare Provider Details

I. General information

NPI: 1306319215
Provider Name (Legal Business Name): WEDNESDAY N TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2019
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3967 E THOUSAND OAKS BLVD STE 250
WESTLAKE VILLAGE CA
91362-6657
US

IV. Provider business mailing address

1911 WILLIAMS DR STE 200
OXNARD CA
93036-0673
US

V. Phone/Fax

Practice location:
  • Phone: 805-760-7393
  • Fax:
Mailing address:
  • Phone: 805-760-7393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number130091
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number130091
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: