Provider Demographics
NPI:1972805497
Name:TAYLOR, THOMAS (PSYD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7850 WHITE LN
Mailing Address - Street 2:SUITE E-176
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-7698
Mailing Address - Country:US
Mailing Address - Phone:415-254-1578
Mailing Address - Fax:
Practice Address - Street 1:7850 WHITE LN
Practice Address - Street 2:SUITE E-176
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-7698
Practice Address - Country:US
Practice Address - Phone:415-254-1578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-04
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23910103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical