Provider Demographics
NPI:1407249667
Name:SCOTT, LYNN
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73750 PICASSO DR
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-4584
Mailing Address - Country:US
Mailing Address - Phone:619-246-9820
Mailing Address - Fax:619-860-1278
Practice Address - Street 1:73750 PICASSO DR
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-4584
Practice Address - Country:US
Practice Address - Phone:619-246-9820
Practice Address - Fax:619-860-1278
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-12
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114820106H00000X
CAIMF78651106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist