Provider Demographics
NPI:1134534704
Name:SCOTT, JASMIN ELLI IGNACIO (DPT)
Entity type:Individual
Prefix:
First Name:JASMIN
Middle Name:ELLI IGNACIO
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JASMIN
Other - Middle Name:ELLI
Other - Last Name:IGNACIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1201 23RD ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-2306
Mailing Address - Country:US
Mailing Address - Phone:661-633-3954
Mailing Address - Fax:661-327-2311
Practice Address - Street 1:2701 CALLOWAY DR
Practice Address - Street 2:#400
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-2621
Practice Address - Country:US
Practice Address - Phone:661-589-9066
Practice Address - Fax:661-589-4209
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41167225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist