Healthcare Provider Details

I. General information

NPI: 1437796547
Provider Name (Legal Business Name): BRITANY R LUNDBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2019
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 V ST # 1100
SACRAMENTO CA
95817-1460
US

IV. Provider business mailing address

4150 V ST # 1100
SACRAMENTO CA
95817-1460
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-2723
  • Fax:
Mailing address:
  • Phone: 916-734-2737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA181383
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA181383
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: