Provider Demographics
NPI:1932876828
Name:GRANT, BRITTNEY (OTR/L, OTD)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:GRANT
Suffix:
Gender:F
Credentials:OTR/L, OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27151 VALIA
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-1316
Mailing Address - Country:US
Mailing Address - Phone:714-642-1718
Mailing Address - Fax:
Practice Address - Street 1:31248 OAK CREST DR STE 120
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-5673
Practice Address - Country:US
Practice Address - Phone:818-239-4891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22091225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist