Basic Information
| Provider Information | |||||||||
| NPI: | 1790398295 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CADIZ | ||||||||
| FirstName: | BRITTANY | ||||||||
| MiddleName: | NICOLE | ||||||||
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| Credential: | PMHNP-BC, RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14659 OLIVE VIEW DR | ||||||||
| Address2: | |||||||||
| City: | SYLMAR | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913421652 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7142536570 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 14659 OLIVE VIEW DR | ||||||||
| Address2: | |||||||||
| City: | SYLMAR | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913421652 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8184850888 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2020 | ||||||||
| LastUpdateDate: | 04/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 95127251 | CA | N | Nursing Service Providers | Registered Nurse | 163WP0809X | 95127251 | CA | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Adult | 363LP0808X | 95017843 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.