Healthcare Provider Details

I. General information

NPI: 1790579191
Provider Name (Legal Business Name): BRITTANY DIANE CIRRINCIONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 08/15/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5273 PROSPECT RD # 183
SAN JOSE CA
95129-5031
US

IV. Provider business mailing address

5273 PROSPECT RD # 183
SAN JOSE CA
95129-5031
US

V. Phone/Fax

Practice location:
  • Phone: 669-225-0501
  • Fax:
Mailing address:
  • Phone: 669-225-0501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: