Provider Demographics
NPI:1740495787
Name:TAYLOR, YEMMY O (PHD)
Entity type:Individual
Prefix:DR
First Name:YEMMY
Middle Name:O
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 PARK PLZ
Mailing Address - Street 2:SUITE 600
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-5910
Mailing Address - Country:US
Mailing Address - Phone:949-633-3065
Mailing Address - Fax:949-651-9211
Practice Address - Street 1:1 PARK PLZ
Practice Address - Street 2:SUITE 600
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-5910
Practice Address - Country:US
Practice Address - Phone:949-633-3065
Practice Address - Fax:949-651-9211
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19148103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical