Provider Demographics
NPI:1750850582
Name:ANGLEY, BRITTANY KEI
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:KEI
Last Name:ANGLEY
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 1:8425 BLACKBURN AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-6503
Mailing Address - Country:US
Mailing Address - Phone:917-974-7322
Mailing Address - Fax:323-452-0170
Practice Address - Street 1:8425 BLACKBURN AVE APT 4
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-6503
Practice Address - Country:US
Practice Address - Phone:917-974-7322
Practice Address - Fax:323-452-0170
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-22
Last Update Date:2018-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0002997171-0001-3343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)