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NPI Code Detail

MEDICARE: DR. BRITTNAE AMANI STALLWORTH PSYD.

MEDICARE: DR. BRITTNAE AMANI STALLWORTH PSYD.
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
1103TC0700XClinical Psychologist36736CA

General Provider Information

NPI Number : 1881174142
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRITTNAE AMANI STALLWORTH PSYD.
Provider Business Mailing Address
First Line : 3828 W CARSON ST STE 100
Second Line :
City : TORRANCE
State : CA
Zip : 90503-6702
Country : US
Telephone Number : 310-787-1335
Fax Number : 310-787-1809
Provider Business Practice Location Address
First Line : 3828 W CARSON ST STE 100
Second Line :
City : TORRANCE
State : CA
Zip : 90503-6702
Country : US
Telephone Number : 310-787-1335
Fax Number : 310-787-1809
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2018
Last Update Date : 05/07/2026

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