Basic Information
| Provider Information | |||||||||
| NPI: | 1447528104 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HART | ||||||||
| FirstName: | BRITTON | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2222 EAST ST STE 305 | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945202066 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9256861230 | ||||||||
| FaxNumber: | 9256868443 | ||||||||
| Practice Location | |||||||||
| Address1: | 2222 EAST ST STE 305 | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945202066 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9256861230 | ||||||||
| FaxNumber: | 9256868443 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/09/2011 | ||||||||
| LastUpdateDate: | 05/31/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | F305694-1 | NY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LA2200X | NP95007683 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
ID Information
| ID | Type | State | Issuer | Description | 01131126RGH/03398414 | 05 | NY | MEDICAID |