Provider Directory Updates - Scripps Health Plan

Provider directory updates for plan members

Thank you for notifying us about an update required to the Scripps Health Plan provider directory. Please use the form below to let us know what needs to be updated or corrected. This form may be used to report errors, omissions and/or address changes.

Please note: The provider directory will be updated upon confirmation of the accuracy of the information submitted and validation of the provider’s contract status. If you would like to check the status of your notification, please call our customer service team at 844-337-3700 or TTY/TDD 888-515-4065 for the hearing or speech impaired.

Fields with an asterisk (*) are required.

Provider Name *

NPI Number

License Type

License Number

Board Certification

Email Address

Address Line 1

Address Line 2

City

State

Zip Code

Additional Office Addresses

Phone Number

Fax Number

Provider Group

Admitting Facilities

Specialties

Languages Spoken

Accepting new patients?: Yes; No

Additional Feedback

Are you a Scripps Health Plan Member: Yes; No

First Name *

Last Name *

Member ID Number

Date of Birth *

Would you like to be contacted: Yes; No

Email Address *

Phone Number *