Healthcare Provider Details

I. General information

NPI: 1043481427
Provider Name (Legal Business Name): MRS. MELISSA ANN SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2008
Last Update Date: 03/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8050 SOQUEL DR STE A
APTOS CA
95003-3981
US

IV. Provider business mailing address

8050 SOQUEL DR STE A
APTOS CA
95003-3981
US

V. Phone/Fax

Practice location:
  • Phone: 831-684-1804
  • Fax: 831-684-1826
Mailing address:
  • Phone: 831-684-1804
  • Fax: 831-684-1826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number6062
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: