Provider Demographics
NPI:1801902614
Name:TAYLOR, PHYLLIS MARY (LMFT)
Entity type:Individual
Prefix:MRS
First Name:PHYLLIS
Middle Name:MARY
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 1:699 HAMPSHIRE RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2351
Mailing Address - Country:US
Mailing Address - Phone:805-558-5228
Mailing Address - Fax:805-374-1774
Practice Address - Street 1:699 HAMPSHIRE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2351
Practice Address - Country:US
Practice Address - Phone:805-558-5228
Practice Address - Fax:805-374-1774
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34443106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist