Active NPI
Glenn Calvin Scott Jr.
- Clinical Social Worker
- Riverside, CA
National Provider Identifier
1083967632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 28479
- Practice address
- 6600 Jurupa Ave Ste 103
Riverside, CA 92504-1041 - Phone
- (951) 840-5322
- NPI assigned
- Oct 19, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 28479 | CA | Primary |
Addresses
Primary practice location
6600 Jurupa Ave Ste 103
Riverside, CA 92504-1041
Mailing address
8692 9TH St Unit 64
Rancho Cucamonga, CA 91730-0812
Phone (951) 849-5322
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28479 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350604800000",
"number": "1083967632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8692 9TH ST UNIT 64",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917300812",
"telephone_number": "951-849-5322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6600 JURUPA AVE STE 103",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925041041",
"telephone_number": "951-840-5322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOTT",
"first_name": "GLENN",
"middle_name": "CALVIN",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-10-19",
"last_updated": "2012-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "28479",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.