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NPI Code Detail

MEDICARE: ANDRAE SCOTT

MEDICARE: ANDRAE SCOTT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health Worker
2171M00000XCase Manager/Care Coordinator
3373H00000XDay Training/Habilitation Specialist
4372600000XAdult CompanionCA

General Provider Information

NPI Number : 1124351119
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDRAE SCOTT
Provider Business Mailing Address
First Line : 3841 N FREEWAY BLVD STE 245
Second Line :
City : SACRAMENTO
State : CA
Zip : 95834-1969
Country : US
Telephone Number : 916-441-0226
Fax Number : 916-441-0286
Provider Business Practice Location Address
First Line : 3841 N FREEWAY BLVD STE 245
Second Line :
City : SACRAMENTO
State : CA
Zip : 95834-1969
Country : US
Telephone Number : 916-441-0226
Fax Number : 916-441-0286
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2009
Last Update Date : 04/13/2026

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Directions to “ ANDRAE SCOTT ” Practice Location

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