Provider Demographics
NPI:1265698310
Name:BRITTAIN, RENEE
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:BRITTAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:
Other - Last Name:DEVERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:TEACHING
Mailing Address - Street 1:30000 SAND CANYON RD
Mailing Address - Street 2:104
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91387-1449
Mailing Address - Country:US
Mailing Address - Phone:661-252-5220
Mailing Address - Fax:
Practice Address - Street 1:30000 SAND CANYON RD
Practice Address - Street 2:104
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91387-1449
Practice Address - Country:US
Practice Address - Phone:661-252-5220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer