Provider Demographics
NPI:1790579191
Name:CIRRINCIONE, BRITTANY DIANE
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:DIANE
Last Name:CIRRINCIONE
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 1:5273 PROSPECT RD # 183
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-5031
Mailing Address - Country:US
Mailing Address - Phone:669-225-0501
Mailing Address - Fax:
Practice Address - Street 1:5273 PROSPECT RD # 183
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-5031
Practice Address - Country:US
Practice Address - Phone:669-225-0501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty