Individual
FANNETTE SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1410 BONITA AVE, BERKELEY, CA 94709-1909
(510) 526-4765
Mailing address
1410 BONITA AVE, BERKELEY, CA 94709-1909
(510) 526-4765
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/15/2018
Last updated
01/13/2025
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