Provider Demographics
NPI:1124649736
Name:TAYLOR, SARAH (CRC, SUDCC II, MRAS)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CRC, SUDCC II, MRAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5632 VAN NUYS BLVD # 1188
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-4602
Mailing Address - Country:US
Mailing Address - Phone:310-467-5267
Mailing Address - Fax:
Practice Address - Street 1:10200 SEPULVEDA BLVD STE 370
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-2692
Practice Address - Country:US
Practice Address - Phone:818-221-3076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)