Healthcare Provider Details

I. General information

NPI: 1083220016
Provider Name (Legal Business Name): MS. BRITTNAY NICHELE STEVENS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 GRAND AVE STE 203
OAKLAND CA
94610-3554
US

IV. Provider business mailing address

4950 OWENS DR APT 817
PLEASANTON CA
94588-4507
US

V. Phone/Fax

Practice location:
  • Phone: 305-726-3731
  • Fax:
Mailing address:
  • Phone: 305-726-3731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number22983
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: