Provider Demographics
NPI:1396273785
Name:WERTZ, BRITTANY FERNANDEZ (DO)
Entity type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:FERNANDEZ
Last Name:WERTZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:BRITTANY
Other - Middle Name:JEAN
Other - Last Name:FERNANDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:678 S INDIAN HILL BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-6000
Mailing Address - Country:US
Mailing Address - Phone:909-399-0101
Mailing Address - Fax:
Practice Address - Street 1:678 S INDIAN HILL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-6000
Practice Address - Country:US
Practice Address - Phone:909-399-0101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-30
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2300X
CA20A17144207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty