Healthcare Provider Details

I. General information

NPI: 1134030430
Provider Name (Legal Business Name): MEAGAN SCRUGGS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 W 18TH ST
UPLAND CA
91784-1682
US

IV. Provider business mailing address

390 N EUCLID AVE STE 100
UPLAND CA
91786-6031
US

V. Phone/Fax

Practice location:
  • Phone: 909-949-7770
  • Fax:
Mailing address:
  • Phone: 909-985-1864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number260130886
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: