Provider Demographics
NPI:1629688213
Name:SCOTT, ALINA ROCHELLE
Entity type:Individual
Prefix:MISS
First Name:ALINA
Middle Name:ROCHELLE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21125 CENTRE POINTE PKWY
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-2994
Mailing Address - Country:US
Mailing Address - Phone:855-435-3801
Mailing Address - Fax:
Practice Address - Street 1:21125 CENTRE POINTE PKWY
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-2994
Practice Address - Country:US
Practice Address - Phone:855-435-3801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-07
Last Update Date:2024-07-02
Deactivation Date:2021-05-25
Deactivation Code:
Reactivation Date:2021-07-07
Provider Licenses
StateLicense IDTaxonomies
CA102214101YM0800X
CAASW102214104100000X
CA1206201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker