Provider Demographics
NPI:1427725787
Name:BEE-BOWMAN, TAYLOR (LMFT)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:BEE-BOWMAN
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:PO BOX 9526
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90295-1926
Mailing Address - Country:US
Mailing Address - Phone:424-371-8208
Mailing Address - Fax:
Practice Address - Street 1:4325 GLENCOE AVE STE C9
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-6444
Practice Address - Country:US
Practice Address - Phone:626-535-3725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-25
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA124035106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist