Provider Demographics
NPI:1851145916
Name:TAYLOR, MONTANA NATALIE (AMFT)
Entity Type:Individual
Prefix:
First Name:MONTANA
Middle Name:NATALIE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4594 ROBBINS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-3033
Mailing Address - Country:US
Mailing Address - Phone:425-785-2762
Mailing Address - Fax:
Practice Address - Street 1:16959 BERNARDO CENTER DR STE 110
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2494
Practice Address - Country:US
Practice Address - Phone:619-281-6414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist