Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
Y | 103G00000X | Clinical Psychologist | PSY8805 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY8805 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1427209949 |
---|---|
Provider Name | Dr. Scott Owen Harris |
First Address | Los Angeles, CA 90049 |
Second Address | Los Angeles, CA 90049 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2008 |
Last Update Date | 27/04/2021 |