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General NPI Number Information
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NPI Number | 1205380193
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Entity Type | Individual
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Provider Name | TAYLOR HAYNES
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Gender | Male
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Dates
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Enumeration Date | 08/08/2016
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Last Update Date | 07/28/2022
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Provider Practice Location Address
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Address Line | 10811 WASHINGTON BLVD
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City | CULVER CITY
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State | CA
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Zip | 90232-3659
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Country | US
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Telephone | 310-945-3350
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Fax | 310-945-3356
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Provider Business Mailing Address
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Address Line | 6306 TUNNEY AVE
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City | TARZANA
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State | CA
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Zip | 91335-6561
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Country | US
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Telephone | 626-590-3687
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Fax | 310-945-3356
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 125082
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License Number State | CA
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