Provider Demographics
NPI:1821616095
Name:ADAMS, SCARLETT MARIE (RN)
Entity Type:Individual
Prefix:
First Name:SCARLETT
Middle Name:MARIE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 TIERRA VIS
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5325
Mailing Address - Country:US
Mailing Address - Phone:949-613-2529
Mailing Address - Fax:
Practice Address - Street 1:31712 VIA ANA
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-3029
Practice Address - Country:US
Practice Address - Phone:949-690-3011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95042589163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health