Provider Demographics
NPI:1588870596
Name:TAYLOR, KIMBERLEY L (PSYD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLEY
Middle Name:L
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 DE LA VINA ST STE F
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-5164
Mailing Address - Country:US
Mailing Address - Phone:805-969-0153
Mailing Address - Fax:
Practice Address - Street 1:1215 DE LA VINA ST STE F
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-5164
Practice Address - Country:US
Practice Address - Phone:805-969-0153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14415103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical