MR. EDDIE RENARD TAYLOR NPI 1326220419

NPI Information

NPI: 1326220419
Provider Name: MR. EDDIE RENARD TAYLOR
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
12450 VAN NUYS BLVD
SUITE 200
PACOIMA, CA
ZIP 91331
Phone: (818) 896-1161
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MR. Eddie Renard Taylor is a mental health counselor in Pacoima, CA. MR. Eddie Renard Taylor NPI is 1326220419. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

12450 VAN NUYS BLVD
SUITE 200
PACOIMA, CA
ZIP 91331-391
Phone: (818) 896-1161

The enumeration date for this NPI number is 11/29/2007 and was last updated on 11/29/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7068	OTHER	CALIFORNIA	OUTPATIENT MENTALHEALTH
2	7068	MEDICARE UPIN	CALIFORNIA
3	7068	OTHER	CALIFORNIA	UPIN MEDICARE MEDICAID
4	7068	OTHER	CALIFORNIA	UPIN
5	7068	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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