Healthcare Provider Details

I. General information

NPI: 1134931330
Provider Name (Legal Business Name): MOSES LEON BRITT NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2025
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 DOLORES AVE
SAN LEANDRO CA
94577-5007
US

IV. Provider business mailing address

201 DOLORES AVE
SAN LEANDRO CA
94577-5007
US

V. Phone/Fax

Practice location:
  • Phone: 510-984-2489
  • Fax:
Mailing address:
  • Phone: 510-984-2489
  • Fax: 510-788-6830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number249781
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95034980
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: