Provider Demographics
NPI:1538991054
Name:SCRIBNER, CHARLES (NP)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:SCRIBNER
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 E KATELLA AVE STE 625
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-5995
Mailing Address - Country:US
Mailing Address - Phone:800-577-4701
Mailing Address - Fax:
Practice Address - Street 1:2401 E KATELLA AVE STE 625
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-5995
Practice Address - Country:US
Practice Address - Phone:800-577-4701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-14
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95031431363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health