MEDICARE: BRITNEY NICHOLE LATHAM

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
1	172V00000X	Community Health Worker		CA

General Provider Information

NPI Number	:	1952264764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITNEY NICHOLE LATHAM

Provider Business Mailing Address
First Line	:	10814 FAIR OAKS BLVD APT 2
Second Line	:
City	:	FAIR OAKS
State	:	CA
Zip	:	95628-7204
Country	:	US
Telephone Number	:	916-484-3570
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 FULTON AVE
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95825-4500
Country	:	US
Telephone Number	:	916-484-3570
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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