Provider Demographics
NPI:1043442940
Name:SCOLA, KERRY GRASER (MS)
Entity Type:Individual
Prefix:MS
First Name:KERRY
Middle Name:GRASER
Last Name:SCOLA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KERRY
Other - Middle Name:ELIZABETH
Other - Last Name:GRASER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:555 NORTHGATE DR
Mailing Address - Street 2:FAMILY SERVICE AGENCY OF MARIN
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-3680
Mailing Address - Country:US
Mailing Address - Phone:415-491-5700
Mailing Address - Fax:415-491-5750
Practice Address - Street 1:555 NORTHGATE DR
Practice Address - Street 2:FAMILY SERVICE AGENCY OF MARIN
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-3680
Practice Address - Country:US
Practice Address - Phone:415-491-5700
Practice Address - Fax:415-491-5750
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59627101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health