Healthcare Provider Details

I. General information

NPI: 1558297523
Provider Name (Legal Business Name): DYLAN HUNTER SCOTT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 ENCINAL ST STE 200
SANTA CRUZ CA
95060-2178
US

IV. Provider business mailing address

380 ENCINAL ST STE 200
SANTA CRUZ CA
95060-2178
US

V. Phone/Fax

Practice location:
  • Phone: 831-469-1700
  • Fax: 831-425-1905
Mailing address:
  • Phone: 831-469-1700
  • Fax: 831-425-1905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: