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NPI Code Detail

MEDICARE: DEBRA LYNN SCOTT SUDCC II

MEDICARE: DEBRA LYNN SCOTT SUDCC II
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
1101YA0400XAddiction (Substance Use Disorder) Counselor16710CA
2376K00000XNurse's Aide16710CA

General Provider Information

NPI Number : 1982813556
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA LYNN SCOTT SUDCC II
Provider Business Mailing Address
First Line : 3730 T ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92113-2848
Country : US
Telephone Number : 619-347-9975
Fax Number :
Provider Business Practice Location Address
First Line : 1341 N ESCONDIDO BLVD
Second Line :
City : ESCONDIDO
State : CA
Zip : 92026-2507
Country : US
Telephone Number : 760-747-1015
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 06/12/2024

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Directions to “ DEBRA LYNN SCOTT SUDCC II” Practice Location

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