Provider Demographics
NPI:1164390688
Name:OSHIMA, SCOTT KEISO (PPS)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:KEISO
Last Name:OSHIMA
Suffix:
Gender:M
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5330 POWER INN RD STE A-3
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-6773
Mailing Address - Country:US
Mailing Address - Phone:916-286-5153
Mailing Address - Fax:
Practice Address - Street 1:5330 POWER INN RD STE A-3
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-6773
Practice Address - Country:US
Practice Address - Phone:916-286-5153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-27
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor