Scott Matthew Taubold, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY20805 Issued in CA

Practice address

347 Cypress St Ste B
Fort Bragg, CA 95437-5458

Phone

(707) 964-5143

NPI assigned

Feb 3, 2007

Last updated

Oct 17, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Bitterroot Family Therapy Inc.

  • Mental Health Counselor
  • Fort Bragg, CA
  • NPI 1003401910
  NPD (past)

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

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1902944580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 S FRANKLIN ST STE B",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375456",
            "telephone_number": "707-961-2669",
            "fax_number": "707-961-2698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 CYPRESS ST STE B",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375458",
            "telephone_number": "707-964-5143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAUBOLD",
        "first_name": "SCOTT",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-03",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY20805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Maria Stewart, RPH
• Anthony Suarez Morales
• Kenneth Roger Susman, M.D.
• James William Swallow, MD
• Tapestry Family Services
• Michele Marie Tellier, FNP
• Marleen Laura Tempelaere
• Theophil Jantz, D.O., Inc
• James A Thomas, PA
• Skyler Thomas, LAC

• Psychologist in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.

Verify at the official NPI Registry.