Provider Demographics
NPI:1104851583
Name:BRITT, ANN RUTLEDGE (MA)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:RUTLEDGE
Last Name:BRITT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5228 IRVINE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-3004
Mailing Address - Country:US
Mailing Address - Phone:818-761-4760
Mailing Address - Fax:818-487-9361
Practice Address - Street 1:11240 MAGNOLIA BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-3790
Practice Address - Country:US
Practice Address - Phone:818-761-4760
Practice Address - Fax:818-487-9361
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT16761106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist