Provider Demographics
NPI:1194854729
Name:TAYLOR, NANCY A (MFT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:A
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:976 LENZEN AVE # 1900
Mailing Address - Street 2:FIRST FLOOR,ROOM #2
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2737
Mailing Address - Country:US
Mailing Address - Phone:408-792-5643
Mailing Address - Fax:408-947-8719
Practice Address - Street 1:976 LENZEN AVE # 1900
Practice Address - Street 2:FIRST FLOOR,ROOM #2
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2737
Practice Address - Country:US
Practice Address - Phone:408-792-5643
Practice Address - Fax:408-947-8719
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT19807101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)