Provider Demographics
NPI:1497453872
Name:SUTLIFF, SCOTT (RBT)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:SUTLIFF
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 CHAUCER DR
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2106
Mailing Address - Country:US
Mailing Address - Phone:831-578-7289
Mailing Address - Fax:
Practice Address - Street 1:103 CHAUCER DR
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2106
Practice Address - Country:US
Practice Address - Phone:831-578-7289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARBT-23-255036106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician