Individual
BRIANNA CAITLIN WIDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHW
Contact information
Practice address
840 N AVENUE 66, LOS ANGELES, CA 90042-1508
(626) 395-7100
Mailing address
100 W WALNUT ST STE 375, PASADENA, CA 91124-0001
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/08/2020
Last updated
05/14/2024
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