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NPI Code Detail

MEDICARE: BRITTANY LEE FOWLER

MEDICARE: BRITTANY LEE FOWLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian86109958CA

General Provider Information

NPI Number : 1861094880
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTANY LEE FOWLER
Provider Business Mailing Address
First Line : 579 PLATEAU CT
Second Line :
City : CAMARILLO
State : CA
Zip : 93010-2156
Country : US
Telephone Number : 818-854-0420
Fax Number :
Provider Business Practice Location Address
First Line : 400 MOBIL AVE STE D9
Second Line :
City : CAMARILLO
State : CA
Zip : 93010-6376
Country : US
Telephone Number : 805-738-5700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2020
Last Update Date : 03/14/2024

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