Healthcare Provider Details

I. General information

NPI: 1447983119
Provider Name (Legal Business Name): NICOLE M BRITTSAN LMFT,APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE MARIE BIRON

II. Dates (important events)

Enumeration Date: 07/08/2022
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 CONTINENTAL BLVD
EL SEGUNDO CA
90245-5076
US

IV. Provider business mailing address

400 CONTINENTAL BLVD
EL SEGUNDO CA
90245-5076
US

V. Phone/Fax

Practice location:
  • Phone: 310-648-0700
  • Fax:
Mailing address:
  • Phone: 310-648-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10037
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number155286
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: