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General NPI Number Information
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NPI Number | 1265669923
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Entity Type | Individual
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Provider Name | MARCELLE BONNEAU TAYLOR MFT
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Gender | Female
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Dates
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Enumeration Date | 06/19/2009
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Last Update Date | 12/14/2025
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Provider Practice Location Address
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Address Line | 1145 W. VALENCIA MESA EMMANUEL EPISCOPAL CHURCH
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City | FULLERTON
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State | CA
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Zip | 92833
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Country | US
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Telephone | 909-985-8092
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Fax | 909-985-8092
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Provider Business Mailing Address
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Address Line | 1477 FRANCIS AVE.
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City | UPLAND
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State | CA
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Zip | 91786
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Country | US
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Telephone | 909-985-8092
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Fax | 909-985-8092
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | ML17129
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License Number State | CA
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