Provider Demographics
NPI:1497357909
Name:HAYSLETT, BRITTNEY VICTORIA
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:VICTORIA
Last Name:HAYSLETT
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 1:939 E AVENUE Q12 APT 240A
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-5345
Mailing Address - Country:US
Mailing Address - Phone:661-573-1012
Mailing Address - Fax:
Practice Address - Street 1:6256 TOPANGA CANYON BLVD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-2282
Practice Address - Country:US
Practice Address - Phone:310-651-9807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225700000X
CA74302225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist