Healthcare Provider Details

I. General information

NPI: 1144997560
Provider Name (Legal Business Name): BRITTANY SALLABERRY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2021
Last Update Date: 12/27/2023
Certification Date: 10/12/2022
Deactivation Date: 10/12/2022
Reactivation Date: 12/27/2023

III. Provider practice location address

5860 SADDLEHORN RD
SHINGLE SPRINGS CA
95682-8598
US

IV. Provider business mailing address

5860 SADDLEHORN RD
SHINGLE SPRINGS CA
95682-8598
US

V. Phone/Fax

Practice location:
  • Phone: 209-256-3871
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number86514
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: