Provider Demographics
NPI:1093879876
Name:SCOTT, BARBARA ELLEN (PT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ELLEN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 SERENO DR.
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94589
Mailing Address - Country:US
Mailing Address - Phone:707-556-3461
Mailing Address - Fax:707-651-4183
Practice Address - Street 1:975 SERENO DR
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2441
Practice Address - Country:US
Practice Address - Phone:707-651-1040
Practice Address - Fax:707-651-4183
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21181225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist