1588007009 NPI number — BRITTANY JO GREGORY LMFT121310

Table of content: BRITTANY JO GREGORY LMFT121310 (NPI 1588007009)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588007009 NPI number — BRITTANY JO GREGORY LMFT121310

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GREGORY
Provider First Name:
BRITTANY
Provider Middle Name:
JO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMFT121310
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588007009
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
150 S NEVADA HIGHWAY 160 STE 8-399
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PAHRUMP
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89048-2176
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
725-272-5298
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
355 GELLERT BLVD STE 257
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALY CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94015-2676
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
725-272-5298
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/15/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  LMFT121310 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)