Provider Demographics
NPI:1922648518
Name:COLE-TAYLOR, LINDA (PHD, LCSW)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:COLE-TAYLOR
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 CAZADOR LN UNIT C
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-6610
Mailing Address - Country:US
Mailing Address - Phone:949-484-8281
Mailing Address - Fax:
Practice Address - Street 1:27611 LA PAZ RD STE A6
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-3999
Practice Address - Country:US
Practice Address - Phone:949-484-8281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-10
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA91662104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker