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General NPI Number Information
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NPI Number | 1700353349
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Entity Type | Individual
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Provider Name | BRITTANY SHIRMAE STAR MITCHELL
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Gender | Female
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Dates
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Enumeration Date | 11/01/2018
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Last Update Date | 03/01/2022
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Provider Practice Location Address
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Address Line | 343 E MAIN ST STE 910
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City | STOCKTON
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State | CA
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Zip | 95202-2990
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Country | US
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Telephone | 209-884-2103
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 81
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City | FRENCH CAMP
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State | CA
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Zip | 95231-0081
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 84247
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 102869
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License Number State | CA
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