Healthcare Provider Details

I. General information

NPI: 1790437044
Provider Name (Legal Business Name): BRITTANY LOREL URBAN CNM, WHNP, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2022
Last Update Date: 07/15/2022
Certification Date: 07/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 MILVIA ST
BERKELEY CA
94704-2636
US

IV. Provider business mailing address

325 DISTEL CIR
LOS ALTOS CA
94022-1408
US

V. Phone/Fax

Practice location:
  • Phone: 510-410-3524
  • Fax: 510-506-7722
Mailing address:
  • Phone: 510-410-3524
  • Fax: 510-506-7722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95018776
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number236219
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: