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NPI 1023232568

NPI 1023232568 : SHERYN T. SCOTT PH.D. : ALTADENA, CA

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General NPI Number Information
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    NPI Number           |    1023232568
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    Entity Type          |    Individual 
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    Provider Name        |    SHERYN T. SCOTT PH.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/13/2007
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    Last Update Date     |    08/06/2007
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Provider Practice Location Address
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    Address Line         |    601 WAPELLO ST 
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    City                 |    ALTADENA
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    State                |    CA
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    Zip                  |    91001-1613
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    Country              |    US
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    Telephone            |    626-797-6010
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    Fax                  |    626-798-7679
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Provider Business Mailing Address
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    Address Line         |    601 WAPELLO ST 
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    City                 |    ALTADENA
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    State                |    CA
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    Zip                  |    91001-1613
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    Country              |    US
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    Telephone            |    626-797-6010
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    Fax                  |    626-798-7679
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    PSY15365
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    License Number State |    CA
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