Provider Demographics
NPI:1073139739
Name:TAYLOR, CHRISTOPHER GEORGE (LMFT, MA)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:GEORGE
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:LMFT, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 CITRACADO PKWY
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-4159
Mailing Address - Country:US
Mailing Address - Phone:760-294-9270
Mailing Address - Fax:
Practice Address - Street 1:2125 CITRACADO PKWY STE 200
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029-4159
Practice Address - Country:US
Practice Address - Phone:740-294-9270
Practice Address - Fax:760-294-9268
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT140176106H00000X
CA129125106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist