Provider Demographics
NPI:1063716462
Name:TAYLOR, KATE BASIA (PHD)
Entity type:Individual
Prefix:DR
First Name:KATE
Middle Name:BASIA
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1081 WESTWOOD BLVD
Mailing Address - Street 2:SUITE 226
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-2911
Mailing Address - Country:US
Mailing Address - Phone:310-248-0645
Mailing Address - Fax:
Practice Address - Street 1:1081 WESTWOOD BLVD
Practice Address - Street 2:SUITE 226
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-2911
Practice Address - Country:US
Practice Address - Phone:310-248-0645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-29
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 23995103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical