Healthcare Provider Details

I. General information

NPI: 1972413565
Provider Name (Legal Business Name): MOLLY ROSE SCOGGINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4880 MARKET ST
VENTURA CA
93003-7783
US

IV. Provider business mailing address

2907 BEACHCOMBER DR E
ROCKLIN CA
95677-4781
US

V. Phone/Fax

Practice location:
  • Phone: 805-725-0640
  • Fax:
Mailing address:
  • Phone: 916-945-1247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: