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General NPI Number Information
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NPI Number | 1568176501
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Entity Type | Organization
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Legal Business Name | CLIFFORDTAYLORPHDPSYCHOLOGICALSERVICESINC
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Dates
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Enumeration Date | 01/12/2023
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 615 BROOKSIDE AVE STE A
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City | REDLANDS
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State | CA
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Zip | 92373-4670
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Country | US
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Telephone | 909-335-8890
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Fax | 909-307-1335
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Provider Business Mailing Address
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Address Line | PO BOX 1963
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City | YUCAIPA
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State | CA
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Zip | 92399-1454
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Country | US
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Telephone | 909-213-2542
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Fax | 909-307-1335
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Authorized Official
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Title or Position | OWNER
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Name | DR. CLIFFORD D TAYLOR
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Credential | PH.D.
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Telephone | 909-213-2542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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