Healthcare Provider Details

I. General information

NPI: 1134598915
Provider Name (Legal Business Name): BRITTANY HURST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2015
Last Update Date: 07/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11705 S ALAMEDA ST
LOS ANGELES CA
90059-2130
US

IV. Provider business mailing address

11705 S ALAMEDA ST
LOS ANGELES CA
90059-2130
US

V. Phone/Fax

Practice location:
  • Phone: 562-773-0398
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: