Basic Information
| Provider Information | |||||||||
| NPI: | 1730580853 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRITO | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | NURSE PRACTITIONER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 224 N FAIR OAKS AVE | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911033618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6266961400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 891 KUHN DR | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | CHULA VISTA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919143551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6197615308 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2014 | ||||||||
| LastUpdateDate: | 10/17/2014 | ||||||||
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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 | NP95001240 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 364SA2100X | CNS4189 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Acute Care |
No ID Information.