Provider Demographics
NPI:1982412045
Name:HOLLY, TAYLOR SENE (NP)
Entity type:Individual
Prefix:MS
First Name:TAYLOR
Middle Name:SENE
Last Name:HOLLY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14320 VENTURA BLVD STE 723
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2717
Mailing Address - Country:US
Mailing Address - Phone:216-413-9108
Mailing Address - Fax:
Practice Address - Street 1:7301 MEDICAL CENTER DR STE 300
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1973
Practice Address - Country:US
Practice Address - Phone:818-651-6245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2024095188363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily