Provider Demographics
NPI:1053322115
Name:SCOTT, DEBORAH SHELLEY (MFT)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:SHELLEY
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:SHELLEY
Other - Last Name:WERTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:1844 SAN MIGUEL DR
Mailing Address - Street 2:STE 306A
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-8610
Mailing Address - Country:US
Mailing Address - Phone:925-256-6451
Mailing Address - Fax:
Practice Address - Street 1:1844 SAN MIGUEL DR
Practice Address - Street 2:STE 306A
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596
Practice Address - Country:US
Practice Address - Phone:925-256-6451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC21975106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist