Provider Demographics
NPI:1063308963
Name:BRENNER, ALLISON RITTER (FNP-C)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:RITTER
Last Name:BRENNER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:ALLISON
Other - Middle Name:GAYLE
Other - Last Name:RITTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3908 HAYFIELD LOOP
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-6241
Mailing Address - Country:US
Mailing Address - Phone:310-908-9928
Mailing Address - Fax:
Practice Address - Street 1:2800 RIVERSIDE AVE STE 101
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-1312
Practice Address - Country:US
Practice Address - Phone:805-238-7250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95035583363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily