Provider Demographics
NPI:1992075170
Name:SCARPITTI, SHAWNA MARIE (ATR-BC)
Entity type:Individual
Prefix:
First Name:SHAWNA
Middle Name:MARIE
Last Name:SCARPITTI
Suffix:
Gender:F
Credentials:ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 E SAN FERNANDO ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-3513
Mailing Address - Country:US
Mailing Address - Phone:408-293-0422
Mailing Address - Fax:408-277-2474
Practice Address - Street 1:484 E SAN FERNANDO ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-3513
Practice Address - Country:US
Practice Address - Phone:408-293-0422
Practice Address - Fax:408-277-2474
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB7633420OtherCA DRIVER LICENSE ID