Basic Information
| Provider Information | |||||||||
| NPI: | 1134580475 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NAYLOR | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | DAVID | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1920 N MARIANNA AVE APT 312 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900324070 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104133587 | ||||||||
| FaxNumber: | 2133512805 | ||||||||
| Practice Location | |||||||||
| Address1: | 3430 COGSWELL RD | ||||||||
| Address2: | |||||||||
| City: | EL MONTE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917322785 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6264533406 | ||||||||
| FaxNumber: | 6262463433 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2016 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 171M00000X | N | Other Service Providers | Case Manager/Care Coordinator | 171M00000X | CA | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.