Provider Demographics
NPI:1417400888
Name:TAYLOR, KATHRYN RAE (LMFT)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:RAE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMFT
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 480806
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-9406
Mailing Address - Country:US
Mailing Address - Phone:310-362-3726
Mailing Address - Fax:
Practice Address - Street 1:5731 W SLAUSON AVE STE 220
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6984
Practice Address - Country:US
Practice Address - Phone:310-362-7626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA119358106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist