Healthcare Provider Details

I. General information

NPI: 1437095544
Provider Name (Legal Business Name): VANESSA SCUDDER AMFT, APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VANESSA FLINN

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 ANZA BLVD STE 332
BURLINGAME CA
94010-1901
US

IV. Provider business mailing address

209 E JAVA DR UNIT 61297
SUNNYVALE CA
94088-8006
US

V. Phone/Fax

Practice location:
  • Phone: 650-212-6307
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number160229
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number21389
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: