Provider Demographics
NPI:1700595923
Name:BOSWORTH, BRIGGS
Entity Type:Individual
Prefix:
First Name:BRIGGS
Middle Name:
Last Name:BOSWORTH
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 1:818 OAKMONT DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-9026
Mailing Address - Country:US
Mailing Address - Phone:530-338-2212
Mailing Address - Fax:
Practice Address - Street 1:3191 CHURN CREEK RD
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2123
Practice Address - Country:US
Practice Address - Phone:530-224-7160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator