Healthcare Provider Details

I. General information

NPI: 1477483782
Provider Name (Legal Business Name): BRITTANI D BURNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 SWALLOW TAIL LN
MANTECA CA
95337-8585
US

IV. Provider business mailing address

1451 SWALLOW TAIL LN
MANTECA CA
95337-8585
US

V. Phone/Fax

Practice location:
  • Phone: 209-889-7284
  • Fax:
Mailing address:
  • Phone: 209-889-7284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: