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NPI Code Detail

MEDICARE: KATHRYN RAE TAYLOR LMFT

MEDICARE: KATHRYN RAE TAYLOR LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist119358CA

General Provider Information

NPI Number : 1417400888
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN RAE TAYLOR LMFT
Provider Business Mailing Address
First Line : PO BOX 480806
Second Line :
City : LOS ANGELES
State : CA
Zip : 90048-9406
Country : US
Telephone Number : 310-362-3726
Fax Number :
Provider Business Practice Location Address
First Line : 5731 W SLAUSON AVE STE 220
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-6984
Country : US
Telephone Number : 310-362-7626
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2016
Last Update Date : 07/14/2021

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Directions to “ KATHRYN RAE TAYLOR LMFT” Practice Location

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