Provider Demographics
NPI:1376057513
Name:LOOKOFSKY, TAYLOR STEVEN
Entity Type:Individual
Prefix:MR
First Name:TAYLOR
Middle Name:STEVEN
Last Name:LOOKOFSKY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11136 ACAMA ST APT 210
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91602-3065
Mailing Address - Country:US
Mailing Address - Phone:818-400-6965
Mailing Address - Fax:
Practice Address - Street 1:9650 ZELZAH AVE
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-2003
Practice Address - Country:US
Practice Address - Phone:818-993-9311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-27
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA132512106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist