Provider Demographics
NPI:1992378533
Name:BRITO, ALEJANDRO ELI
Entity Type:Individual
Prefix:MR
First Name:ALEJANDRO
Middle Name:ELI
Last Name:BRITO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13002 MARSHALL LN
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-1817
Mailing Address - Country:US
Mailing Address - Phone:714-319-8724
Mailing Address - Fax:
Practice Address - Street 1:701 W KIMBERLY AVE
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-6342
Practice Address - Country:US
Practice Address - Phone:714-780-2282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician