Provider Demographics
NPI:1245251818
Name:SCOTT, JO ANN M (DC)
Entity type:Individual
Prefix:
First Name:JO ANN
Middle Name:M
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30100 CROWN VALLEY PKWY STE 16
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-2041
Mailing Address - Country:US
Mailing Address - Phone:949-249-2720
Mailing Address - Fax:924-249-1846
Practice Address - Street 1:30100 CROWN VALLEY PKWY STE 16
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-2041
Practice Address - Country:US
Practice Address - Phone:949-249-2720
Practice Address - Fax:924-249-1846
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21541111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC21541Medicare PIN