Individual provider Active NPI

Katelynn Marie Scott

  • Marriage & Family Therapist
  • Yucaipa, CA
National Provider Identifier
1376173021
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
139099 Issued in CA
Practice address
34324 Yucaipa Blvd Ste C
Yucaipa, CA 92399-2496
Phone
(877) 527-7227
NPI assigned
Jan 22, 2020
Last updated
Nov 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 139099 CA Primary
Marriage & Family Therapist 106H00000X

Addresses

Primary practice location

34324 Yucaipa Blvd Ste C
Yucaipa, CA 92399-2496

Mailing address

27261 Ramblas, Suite 220
Mission Viejo, CA 92691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241231001034 CA Practitioner - Marriage and Family Therapist 9335676469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1301 California St
Redlands, CA 92374-2910
Phone (909) 809-3222

9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
139099CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Oct 28, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 28, 2024 Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1376173021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27261 RAMBLAS, SUITE 220",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34324 YUCAIPA BLVD STE C",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923992496",
            "telephone_number": "877-527-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "KATELYNN",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-22",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "139099",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucaipa, CA

Sources for this page

Verify at the official NPI Registry.