Provider Demographics
NPI:1417571506
Name:TAYLOR, ERICA THERESE
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:THERESE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ERICA
Other - Middle Name:THERESE
Other - Last Name:CASTILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:250 KAPILI ST APT 10
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-3165
Mailing Address - Country:US
Mailing Address - Phone:808-379-7073
Mailing Address - Fax:
Practice Address - Street 1:250 KAPILI ST APT 10
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-3165
Practice Address - Country:US
Practice Address - Phone:808-379-7073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-03
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI655106H00000X
TX204706106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist