Provider Demographics
NPI:1659402204
Name:TAYLOR, DINA F (LMFT)
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:F
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 E PALMDALE BLVD
Mailing Address - Street 2:SUITE G. #C-49
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-4959
Mailing Address - Country:US
Mailing Address - Phone:818-645-7308
Mailing Address - Fax:
Practice Address - Street 1:190 SIERRA CT
Practice Address - Street 2:SUITE C-8
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-7607
Practice Address - Country:US
Practice Address - Phone:661-266-4783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT28767106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist