=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912528829
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRITTANI NICHOLE LASKI FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/01/2020
-----------------------------------------------------
Last Update Date | 11/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2492 WALNUT AVE STE 100
-----------------------------------------------------
City | TUSTIN
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92780-6953
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-709-8000
-----------------------------------------------------
Fax | 714-709-8080
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2492 WALNUT AVE STE 100
-----------------------------------------------------
City | TUSTIN
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92780-6953
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-709-8000
-----------------------------------------------------
Fax | 714-709-8080
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Nurse Practitioner
-----------------------------------------------------
License Number | 95013914
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------