Provider Demographics
NPI:1922187194
Name:WHITELEY, SCOTT MORRIS (PHD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:MORRIS
Last Name:WHITELEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 302
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93116-0302
Mailing Address - Country:US
Mailing Address - Phone:805-679-1879
Mailing Address - Fax:
Practice Address - Street 1:2021 SPERRY AVE STE 44
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7417
Practice Address - Country:US
Practice Address - Phone:805-679-1879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 11319103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist