Provider Demographics
NPI:1023847514
Name:LAUREN-TAYLOR, PAIGE ELAINE (AMFT)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:ELAINE
Last Name:LAUREN-TAYLOR
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:ELAINE
Other - Last Name:LAUREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12626 RIVERSIDE DR STE 409
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3451
Mailing Address - Country:US
Mailing Address - Phone:818-661-6306
Mailing Address - Fax:818-666-0221
Practice Address - Street 1:12626 RIVERSIDE DR STE 409
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-3451
Practice Address - Country:US
Practice Address - Phone:818-661-6306
Practice Address - Fax:818-666-0221
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT148489106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist