Provider Demographics
NPI:1447983119
Name:BRITTSAN, NICOLE M (AMFT,APCC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:M
Last Name:BRITTSAN
Suffix:
Gender:F
Credentials:AMFT,APCC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:MARIE
Other - Last Name:BIRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 CONTINENTAL BLVD
Mailing Address - Street 2:
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-5076
Mailing Address - Country:US
Mailing Address - Phone:310-648-0700
Mailing Address - Fax:
Practice Address - Street 1:400 CONTINENTAL BLVD
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-5076
Practice Address - Country:US
Practice Address - Phone:310-648-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-08
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA155286106H00000X
CA10037101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist