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General NPI Number Information
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NPI Number | 1811487598
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Entity Type | Organization
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Legal Business Name | TAYLOR PSYCHOLOGICAL INNOVATORS INC.
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Dates
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Enumeration Date | 05/17/2018
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 44 VISITACION AVE STE 103
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City | BRISBANE
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State | CA
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Zip | 94005-1575
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Country | US
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Telephone | 415-866-8508
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Fax |
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Provider Business Mailing Address
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Address Line | 44 VISITACION AVE STE 103
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City | BRISBANE
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State | CA
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Zip | 94005-1575
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Country | US
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Telephone | 415-508-9290
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ENNA EMPERATRIZ TAYLOR
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Credential | PSYD
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Telephone | 415-866-8508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | PSY29272
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License Number State | CA
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Taxonomy #2
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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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