Kim Scott, ED.D

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1538-061511P Issued in CA

Practice address

15643 Dobbs Peak LN
Fontana, CA 92336-4560

Phone

(951) 536-7845

NPI assigned

May 7, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273190400000",
    "number": "1053639583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15643 DOBBS PEAK LN",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923364560",
            "telephone_number": "951-536-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15643 DOBBS PEAK LN",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923364560",
            "telephone_number": "951-536-7845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "KIM",
        "name_prefix": "Mrs.",
        "credential": "ED.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-07",
        "last_updated": "2010-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "1538-061511P",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "CA",
            "license": "070104802",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William J Schork, CRNA
• Susan Y Schroeter, PHARMD
• Carla Schuermann-Berryman, M.D.
• Kevin Schuman, R.T.
• Cheryl Schwartzwald, M.D
• Nova Marie Scott
• Nyasha Michelle Scott, DDS
• Torrian Tashaun Scott
• William S. Scott, MD
• Aja Latyoa Sealey

• Addiction (Substance Use Disorder) Counselor in Fontana, CA
• Providers in Fontana, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.