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General NPI Number Information
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NPI Number | 1801486048
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Entity Type | Organization
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Legal Business Name | TAYLORMADE COUNSELING & CONSULTING, LLC
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Dates
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Enumeration Date | 01/21/2021
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 36330 HIDDEN SPRINGS RD # E6
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City | WILDOMAR
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State | CA
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Zip | 92595-5803
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Country | US
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Telephone | 951-500-7636
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Fax |
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Provider Business Mailing Address
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Address Line | 36330 HIDDEN SPRINGS RD STE E
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City | WILDOMAR
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State | CA
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Zip | 92595-5804
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Country | US
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Telephone | 951-500-7636
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Fax | 951-848-9916
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Authorized Official
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Title or Position | OFFICE ADMIN/BILLING
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Name | DEBRA TAYLOR
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Credential |
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Telephone | 951-500-7636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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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 | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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