Provider Demographics
NPI:1447266606
Name:TAYLOR, M KATHRYN (MFT)
Entity type:Individual
Prefix:MS
First Name:M
Middle Name:KATHRYN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:MARTHA
Other - Middle Name:KATHRYN
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:PO BOX 162393
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-2393
Mailing Address - Country:US
Mailing Address - Phone:916-400-1075
Mailing Address - Fax:916-456-1953
Practice Address - Street 1:2710 X ST
Practice Address - Street 2:SUITE 2-A
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95818-2757
Practice Address - Country:US
Practice Address - Phone:916-400-1075
Practice Address - Fax:916-456-1953
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 29307106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist