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General NPI Number Information
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NPI Number | 1346501533
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Entity Type | Individual
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Provider Name | CORRDERO TAYLOR MSW, LCSW
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Gender | Male
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Dates
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Enumeration Date | 06/04/2012
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 6500 WILSHIRE BLVD FL 19
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City | LOS ANGELES
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State | CA
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Zip | 90048-4920
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Country | US
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Telephone | 805-764-9651
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Fax |
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Provider Business Mailing Address
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Address Line | 14068 GRAHAM ST # 202
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City | MORENO VALLEY
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State | CA
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Zip | 92553-8830
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Country | US
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Telephone | 562-704-6779
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Fax | 562-207-5166
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW71284
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License Number State | CA
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