Provider Demographics
NPI:1629154398
Name:WHITING-SCOTT, NANCY (PT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:WHITING-SCOTT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 WRIGHT ST
Mailing Address - Street 2:SUITE C-1
Mailing Address - City:LA VERNE
Mailing Address - State:CA
Mailing Address - Zip Code:91750-5814
Mailing Address - Country:US
Mailing Address - Phone:909-392-3460
Mailing Address - Fax:909-392-3140
Practice Address - Street 1:2125 WRIGHT ST
Practice Address - Street 2:SUITE C-1
Practice Address - City:LA VERNE
Practice Address - State:CA
Practice Address - Zip Code:91750-5814
Practice Address - Country:US
Practice Address - Phone:909-392-3460
Practice Address - Fax:909-392-3140
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT705202251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics