Provider Demographics
NPI:1699394965
Name:GARCIA, BRITTANY MAY (RADT-1)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MAY
Last Name:GARCIA
Suffix:
Gender:F
Credentials:RADT-1
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:MAY
Other - Last Name:LABASS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1111 E COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95205-3313
Mailing Address - Country:US
Mailing Address - Phone:209-993-4508
Mailing Address - Fax:
Practice Address - Street 1:541 S HAM LN
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95242-3059
Practice Address - Country:US
Practice Address - Phone:209-224-8940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-15
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)