MEDICARE: TAYLOR ASHLEY PHILIPS LCSW

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
1	1041C0700X	Clinical Social Worker	111299	CA
2	1041C0700X	Clinical Social Worker	135054	CA
3	101Y00000X	Counselor		CA

General Provider Information

NPI Number	:	1922632983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR ASHLEY PHILIPS LCSW

Provider Business Mailing Address
First Line	:	846 PEARL PL
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-5831
Country	:	US
Telephone Number	:	858-880-6890
Fax Number	:

Provider Business Practice Location Address
First Line	:	8787 COMPLEX DR STE 300
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1453
Country	:	US
Telephone Number	:	619-643-8487
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2020
Last Update Date	:	06/08/2026

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