Provider Demographics
NPI:1235220674
Name:TAYLOR, NANCY J (PHD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:J
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 59583
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90652
Mailing Address - Country:US
Mailing Address - Phone:714-508-7335
Mailing Address - Fax:951-738-0831
Practice Address - Street 1:242 WEST MAIN STREET
Practice Address - Street 2:SUITE 104
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780
Practice Address - Country:US
Practice Address - Phone:714-508-7335
Practice Address - Fax:951-738-0831
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16552103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist