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General NPI Number Information
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NPI Number | 1972620078
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Entity Type | Individual
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Provider Name | DERYL TAYLOR LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 03/30/2018
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Provider Practice Location Address
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Address Line | 1012 E COOLEY DR STE B
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City | COLTON
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State | CA
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Zip | 92324-3959
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Country | US
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Telephone | 951-570-7823
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Fax | 888-356-9214
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Provider Business Mailing Address
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Address Line | 10030 VIA PESCADERO
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City | MORENO VALLEY
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State | CA
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Zip | 92557-2746
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Country | US
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Telephone | 951-385-5013
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Fax | 951-485-1959
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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 | 19190
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License Number State | CA
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