Provider Demographics
NPI:1619240645
Name:TAYLOR, RACHEL (BCBA,D)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:BCBA,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11620 WILSHIRE BLVD
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1706
Mailing Address - Country:US
Mailing Address - Phone:310-997-0571
Mailing Address - Fax:818-671-2774
Practice Address - Street 1:11620 WILSHIRE BLVD
Practice Address - Street 2:9TH FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1706
Practice Address - Country:US
Practice Address - Phone:310-997-0571
Practice Address - Fax:818-671-2774
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-06-2765103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst