Provider Demographics
NPI:1861269185
Name:LANGEVIN, BRITTANY MICHELLE
Entity type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:MICHELLE
Last Name:LANGEVIN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:BRITTANY
Other - Middle Name:MICHELLE
Other - Last Name:HAGGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 E VALENCIA MESA DR OFC 235
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3809
Mailing Address - Country:US
Mailing Address - Phone:714-992-3000
Mailing Address - Fax:714-447-6420
Practice Address - Street 1:101 E VALENCIA MESA DR OFC 235
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3809
Practice Address - Country:US
Practice Address - Phone:714-992-3000
Practice Address - Fax:714-447-6420
Is Sole Proprietor?:No
Enumeration Date:2023-12-06
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA767522163W00000X
390200000X
CA95030810363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program