Basic Information
| Provider Information | |||||||||
| NPI: | 1912289232 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCOTT | ||||||||
| FirstName: | ERIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 28637 VISTA MADERA | ||||||||
| Address2: | |||||||||
| City: | RANCHO PALOS VERDES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902750869 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8503397929 | ||||||||
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| Practice Location | |||||||||
| Address1: | 490 W 14TH ST | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908132943 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5625918701 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2011 | ||||||||
| LastUpdateDate: | 09/13/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | ASW29485 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.