Healthcare Provider Details

I. General information

NPI: 1033453691
Provider Name (Legal Business Name): BRITTNEY DAWN MASSIE M.A. LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2012
Last Update Date: 09/08/2021
Certification Date: 09/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12240 HESPERIA RD STE A
VICTORVILLE CA
92395-8309
US

IV. Provider business mailing address

12240 HESPERIA RD STE A
VICTORVILLE CA
92395-8309
US

V. Phone/Fax

Practice location:
  • Phone: 760-245-8837
  • Fax: 760-245-8854
Mailing address:
  • Phone: 760-245-8837
  • Fax: 760-245-8834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number90947
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: