Provider Demographics
NPI:1073881470
Name:REYNOSO, BRITTNEY DAWN (PA)
Entity Type:Individual
Prefix:MRS
First Name:BRITTNEY
Middle Name:DAWN
Last Name:REYNOSO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:BRITTNEY
Other - Middle Name:DAWN
Other - Last Name:SCHOMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:6556 LONETREE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5874
Mailing Address - Country:US
Mailing Address - Phone:916-781-9000
Mailing Address - Fax:916-781-9020
Practice Address - Street 1:6556 LONETREE BLVD
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-5874
Practice Address - Country:US
Practice Address - Phone:916-781-9000
Practice Address - Fax:916-781-9020
Is Sole Proprietor?:No
Enumeration Date:2011-12-13
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16292363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical