Provider Demographics
NPI:1730580853
Name:BRITO, MELISSA ANN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:BRITO
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 N FAIR OAKS AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-3618
Mailing Address - Country:US
Mailing Address - Phone:626-696-1400
Mailing Address - Fax:
Practice Address - Street 1:891 KUHN DR
Practice Address - Street 2:SUITE 106
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-3551
Practice Address - Country:US
Practice Address - Phone:619-761-5308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95001240363LA2200X
CACNS4189364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care