Provider Demographics
NPI:1619191566
Name:TAYLOR, DEBRA LARAINE (MFT)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:LARAINE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 HIGH POINT DR
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-1410
Mailing Address - Country:US
Mailing Address - Phone:805-443-5530
Mailing Address - Fax:805-659-5729
Practice Address - Street 1:500 HIGH POINT DR
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-1410
Practice Address - Country:US
Practice Address - Phone:805-644-1650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC20400106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist