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General NPI Number Information
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NPI Number | 1508096967
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Entity Type | Individual
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Provider Name | KIMBERLY COLEEN TAYLOR LMFT 93627
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Gender | Female
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Dates
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Enumeration Date | 07/20/2009
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Last Update Date | 06/12/2018
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Provider Practice Location Address
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Address Line | 17011 BEACH BLVD STE 900
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-5998
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Country | US
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Telephone | 949-424-9681
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Fax |
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Provider Business Mailing Address
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Address Line | 668 N. PACIFIC COAST HIGHWAY #1112
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-2667
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Country | US
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Telephone | 949-424-9681
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Fax |
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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 | 93627
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License Number State | CA
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