Provider Demographics
NPI:1417484312
Name:PATRICIA WANSLEY TAYLOR, LMFT
Entity Type:Organization
Organization Name:PATRICIA WANSLEY TAYLOR, LMFT
Other - Org Name:COLLABORATIVE PSYCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LFMT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-585-5680
Mailing Address - Street 1:2204 S EL CAMINO REAL STE 205
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6389
Mailing Address - Country:US
Mailing Address - Phone:760-585-5680
Mailing Address - Fax:844-373-1890
Practice Address - Street 1:2204 S EL CAMINO REAL STE 205
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6389
Practice Address - Country:US
Practice Address - Phone:760-585-5680
Practice Address - Fax:844-373-1890
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PATRICIA WANSLEY TAYLOR, LMFT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85355261QM0801X, 261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health