Provider Demographics
NPI:1184817041
Name:TAYLOR, THAO T (PSYD)
Entity Type:Individual
Prefix:DR
First Name:THAO
Middle Name:T
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16625 KNAPP ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-3608
Mailing Address - Country:US
Mailing Address - Phone:818-723-5435
Mailing Address - Fax:
Practice Address - Street 1:16055 VENTURA BLVD
Practice Address - Street 2:STE 1112
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2612
Practice Address - Country:US
Practice Address - Phone:818-284-4006
Practice Address - Fax:818-377-5044
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health