Provider Demographics
NPI:1184940538
Name:TAYLOR, KAREN YVONNE (MFC)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:YVONNE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MFC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 MOORPARK AVE STE 118
Mailing Address - Street 2:118
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95117
Mailing Address - Country:US
Mailing Address - Phone:408-455-8220
Mailing Address - Fax:
Practice Address - Street 1:4010 MOORPARK AVE
Practice Address - Street 2:SUITE 118
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95117
Practice Address - Country:US
Practice Address - Phone:408-455-8220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2024-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT45123106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist