Provider Demographics
NPI:1205983335
Name:SCOTT, PATRICIA MEYER (PT)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:MEYER
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:PATRICIA
Other - Middle Name:ANN
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:564 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-1316
Mailing Address - Country:US
Mailing Address - Phone:707-746-6487
Mailing Address - Fax:
Practice Address - Street 1:2817 CROW CANYON RD
Practice Address - Street 2:SUITE 104
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1639
Practice Address - Country:US
Practice Address - Phone:925-838-9846
Practice Address - Fax:925-838-3254
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT8816225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00PT88161OtherPPIN
CAR27144Medicare UPIN
CAZZZ03607ZMedicare ID - Type UnspecifiedGROUP