Provider Demographics
NPI:1255512158
Name:TAYLOR, SHAYLALE QUINSHA
Entity type:Individual
Prefix:
First Name:SHAYLALE
Middle Name:QUINSHA
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3622 E AVENUE H13
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-2225
Mailing Address - Country:US
Mailing Address - Phone:661-946-2368
Mailing Address - Fax:
Practice Address - Street 1:43424 COPELAND CIR STE A
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-4503
Practice Address - Country:US
Practice Address - Phone:661-726-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist