Provider Demographics
NPI:1609531706
Name:SCOTT, JENA
Entity Type:Individual
Prefix:
First Name:JENA
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENA
Other - Middle Name:
Other - Last Name:BERK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21021 VANOWEN ST APT G201
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-4014
Mailing Address - Country:US
Mailing Address - Phone:661-714-0887
Mailing Address - Fax:
Practice Address - Street 1:21021 VANOWEN ST APT G201
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-4014
Practice Address - Country:US
Practice Address - Phone:661-714-0887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula