Healthcare Provider Details

I. General information

NPI: 1679163349
Provider Name (Legal Business Name): BRITTANY CHRISTIAN BURNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2021
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1513 S GRAND AVE STE 200
LOS ANGELES CA
90015-3075
US

IV. Provider business mailing address

PO BOX 7092
PASADENA CA
91109-7092
US

V. Phone/Fax

Practice location:
  • Phone: 833-438-8763
  • Fax: 833-438-8700
Mailing address:
  • Phone: 833-438-8763
  • Fax: 833-438-8700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95128391
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number95128391
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95023142
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: