Provider Demographics
NPI:1609396191
Name:SCOTT, MONICA E (RNIII)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:E
Last Name:SCOTT
Suffix:
Gender:F
Credentials:RNIII
Other - Prefix:MISS
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:SPARKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:M,SCOTT RNIII
Mailing Address - Street 1:1325 BROAD AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:90744-2604
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1325 BROAD AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:CA
Practice Address - Zip Code:90744-2604
Practice Address - Country:US
Practice Address - Phone:310-404-2141
Practice Address - Fax:310-404-2166
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA691386163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care