MEDICARE: BRITTANY HOLTZCLAW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program		CA
2	1041C0700X	Clinical Social Worker	11435-C	NV

General Provider Information

NPI Number	:	1568612711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY HOLTZCLAW

Provider Business Mailing Address
First Line	:	6387 JOSHUA PEAK AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-6178
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6387 JOSHUA PEAK AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-6178
Country	:	US
Telephone Number	:	209-648-1767
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2008
Last Update Date	:	12/30/2025

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Directions to “ BRITTANY HOLTZCLAW ” Practice Location

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