Healthcare Provider Details

I. General information

NPI: 1104772748
Provider Name (Legal Business Name): BRYTINY HOWARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12884 SHAWNEE ST
MORENO VALLEY CA
92555-3533
US

IV. Provider business mailing address

12884 SHAWNEE ST
MORENO VALLEY CA
92555-3533
US

V. Phone/Fax

Practice location:
  • Phone: 323-437-5731
  • Fax:
Mailing address:
  • Phone: 323-437-5731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: