Provider Demographics
NPI:1033236567
Name:TAYLOR, NECKO R
Entity Type:Individual
Prefix:MRS
First Name:NECKO
Middle Name:R
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 N ALAMEDA ST
Mailing Address - Street 2:3221 N. ALAMEDA STREET, SUITE G
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90222-1433
Mailing Address - Country:US
Mailing Address - Phone:310-537-9780
Mailing Address - Fax:310-537-9756
Practice Address - Street 1:3221 N ALAMEDA ST
Practice Address - Street 2:3221 N. ALAMEDA STREET, SUITE G
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90222-1433
Practice Address - Country:US
Practice Address - Phone:310-537-9780
Practice Address - Fax:310-537-9756
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 11485101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health