Individual provider Active NPI

Taylor Comstock

  • Marriage & Family Therapist
  • San Bernardino, CA
National Provider Identifier
1235685850
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
120210 Issued in CA
Practice address
658 E Brier Dr Suite 200
San Bernardino, CA 92415-1622
Phone
(909) 501-0700
NPI assigned
Sep 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CA
Mental Health Counselor 101YM0800X IMF95248
Marriage & Family Therapist 106H00000X
Marriage & Family Therapist 106H00000X AMFT95248 CA
Marriage & Family Therapist 106H00000X 120210 CA Primary

Addresses

Primary practice location

658 E Brier Dr Suite 200
San Bernardino, CA 92415-1622

Mailing address

658 E Brier Dr Suite 200
San Bernardino, CA 92415-1622
Phone (909) 501-0700

Other identifiers 1

IdentifierTypeStateIssuer
101YA0400XMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
120210CAMDSocial Worker
AMFT95248CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Bernardino PastSince Nov 17, 2019 Accepting new patients
County of San Bernardino PastSince Nov 17, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1235685850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 E BRIER DR SUITE 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924151622",
            "telephone_number": "909-501-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 E BRIER DR SUITE 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924151622",
            "telephone_number": "909-501-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMSTOCK",
        "first_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "IMF95248",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT95248",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "120210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YA0400X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.