Provider Demographics
NPI:1447312533
Name:TAYLOR, BEVERLY CHRISTA (MFT)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:CHRISTA
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-4504
Mailing Address - Country:US
Mailing Address - Phone:805-346-1999
Mailing Address - Fax:
Practice Address - Street 1:2029 VILLAGE LN STE 201
Practice Address - Street 2:
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-3217
Practice Address - Country:US
Practice Address - Phone:805-697-7756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 41786106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist