Provider Demographics
NPI:1487351698
Name:THOMAS-VESTAL, BRITTANY R (LCSW)
Entity type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:R
Last Name:THOMAS-VESTAL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4070 CLOVER VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-1510
Mailing Address - Country:US
Mailing Address - Phone:916-417-5061
Mailing Address - Fax:
Practice Address - Street 1:4070 CLOVER VALLEY RD
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-1510
Practice Address - Country:US
Practice Address - Phone:916-417-5061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW234411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical