Provider Demographics
NPI:1851581359
Name:AMUNDSEN, BRITTA INGRID
Entity Type:Individual
Prefix:MS
First Name:BRITTA
Middle Name:INGRID
Last Name:AMUNDSEN
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 1:2781 HIGHVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-5123
Mailing Address - Country:US
Mailing Address - Phone:626-398-7463
Mailing Address - Fax:
Practice Address - Street 1:7101 BAIRD AVE
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4150
Practice Address - Country:US
Practice Address - Phone:818-342-5897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor