Provider Demographics
NPI:1750417457
Name:SCARBOROUGH, DEAN
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:
Last Name:SCARBOROUGH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6333 TELEGRAPH AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1359
Mailing Address - Country:US
Mailing Address - Phone:510-923-1099
Mailing Address - Fax:
Practice Address - Street 1:6333 TELEGRAPH AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1359
Practice Address - Country:US
Practice Address - Phone:510-923-1099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No172V00000XOther Service ProvidersCommunity Health Worker
No174400000XOther Service ProvidersSpecialist