Provider Demographics
NPI:1609190214
Name:NEVEN, SCOTT (OTR/L)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:NEVEN
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 53738
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95153-0738
Mailing Address - Country:US
Mailing Address - Phone:408-569-4956
Mailing Address - Fax:408-226-6412
Practice Address - Street 1:2995 ROSSMORE WAY
Practice Address - Street 2:ROOM 35
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-3527
Practice Address - Country:US
Practice Address - Phone:408-569-4956
Practice Address - Fax:408-226-6412
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7622174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist