Provider Demographics
NPI:1639241201
Name:SCOTT, CHRISTINE ANNE (MA, IMF)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:ANNE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MA, IMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 LA CORONILLA DR
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93109-1618
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1236 CHAPALA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-3116
Practice Address - Country:US
Practice Address - Phone:805-965-2376
Practice Address - Fax:805-963-6707
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 51292101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3601Medicaid