Provider Demographics
NPI:1396401592
Name:DIFFINE, BRITTNEY MARIE
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:MARIE
Last Name:DIFFINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:738 VIA LA PALOMA
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-6403
Mailing Address - Country:US
Mailing Address - Phone:951-329-0230
Mailing Address - Fax:
Practice Address - Street 1:738 VIA LA PALOMA
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-6403
Practice Address - Country:US
Practice Address - Phone:951-329-0230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60660363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical