Provider Demographics
NPI:1467617324
Name:SCOTT, ANDREW WALTHER (PHD, MA)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:WALTHER
Last Name:SCOTT
Suffix:
Gender:M
Credentials:PHD, MA
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:ANDREW
Other - Last Name:WALTHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:126 E HALEY ST STE A11
Mailing Address - Street 2:C.O. MARIELA MARIN, DIRECTOR OF COUNSELING AND RECOVERY
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2389
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8950 VILLA LA JOLLA DR STE C121
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1707
Practice Address - Country:US
Practice Address - Phone:888-699-4873
Practice Address - Fax:805-472-6099
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health