Provider Demographics
NPI:1396590428
Name:BRITO, BRITTANY ROSE (CPT-1)
Entity type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:ROSE
Last Name:BRITO
Suffix:
Gender:F
Credentials:CPT-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31015 LAUSANNE ST
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-7335
Mailing Address - Country:US
Mailing Address - Phone:951-314-8203
Mailing Address - Fax:
Practice Address - Street 1:31015 LAUSANNE ST
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-7335
Practice Address - Country:US
Practice Address - Phone:951-314-8203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPT-00052037246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy