Provider Demographics
NPI:1588952626
Name:SCOTT, DERIK AARON
Entity type:Individual
Prefix:MR
First Name:DERIK
Middle Name:AARON
Last Name:SCOTT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16350 SAINT JOHN CT
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-7861
Mailing Address - Country:US
Mailing Address - Phone:408-772-9913
Mailing Address - Fax:
Practice Address - Street 1:16350 SAINT JOHN CT
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-7861
Practice Address - Country:US
Practice Address - Phone:408-772-9913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health