Provider Demographics
NPI:1164438255
Name:TAYLOR, JOSHUA MANN (PSYCHOLOGIST)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:MANN
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 W 5TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-4519
Mailing Address - Country:US
Mailing Address - Phone:714-834-3840
Mailing Address - Fax:
Practice Address - Street 1:405 W 5TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-4519
Practice Address - Country:US
Practice Address - Phone:714-834-3840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CAPSB31319103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist