Provider Demographics
NPI:1588032619
Name:GUTHRIE, TAYLOR L (LCSW)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:L
Last Name:GUTHRIE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 UCLA MEDICAL PLZ
Mailing Address - Street 2:SUITE 4238F
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-1718
Mailing Address - Country:US
Mailing Address - Phone:310-267-9193
Mailing Address - Fax:
Practice Address - Street 1:150 UCLA MEDICAL PLZ
Practice Address - Street 2:SUITE 4238F
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-1718
Practice Address - Country:US
Practice Address - Phone:310-267-9193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-06
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA725211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical