Individual
MRS. BRITTANY LANG BONGGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
17051 SIERRA LAKES PKWY STE 101, FONTANA, CA 92336-1274
(909) 428-2040
(909) 428-2191
Mailing address
3400 DATA DR, CREDENTIALING DEPARTMENT, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95004741
CA
Other
Enumeration date
09/01/2016
Last updated
04/25/2022
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