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General NPI Number Information
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NPI Number | 1821671694
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Entity Type | Individual
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Provider Name | KAYLEE MARIE SCOTT-VAN DEUSEN DPT
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Gender | Female
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Dates
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Enumeration Date | 04/30/2021
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Last Update Date | 04/30/2021
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Provider Practice Location Address
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Address Line | 4500 GILBERT ST
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City | OAKLAND
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State | CA
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Zip | 94611-4657
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Country | US
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Telephone | 412-999-5695
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Fax |
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Provider Business Mailing Address
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Address Line | 2515 BEST AVE
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City | OAKLAND
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State | CA
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Zip | 94601-5507
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Country | US
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Telephone | 412-999-5695
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 299802
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License Number State | CA
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