Provider Demographics
NPI:1043916133
Name:LIVINGSTONE, JOHN SCOTT
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:SCOTT
Last Name:LIVINGSTONE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21402 LITTLE VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-9819
Mailing Address - Country:US
Mailing Address - Phone:714-271-2455
Mailing Address - Fax:
Practice Address - Street 1:22675 HILLS RANCH RD
Practice Address - Street 2:
Practice Address - City:NUEVO
Practice Address - State:CA
Practice Address - Zip Code:92567
Practice Address - Country:US
Practice Address - Phone:714-271-2455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)