Healthcare Provider Details

I. General information

NPI: 1104455914
Provider Name (Legal Business Name): CECILEY SCARBROUGH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2020
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5120 WOODLEY AVE
ENCINO CA
91436-1443
US

IV. Provider business mailing address

5120 WOODLEY AVE
ENCINO CA
91436-1443
US

V. Phone/Fax

Practice location:
  • Phone: 628-432-7476
  • Fax: 321-346-7133
Mailing address:
  • Phone: 628-432-7476
  • Fax: 321-346-7133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number312444
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: