Provider Demographics
NPI:1215685128
Name:GUCCIARDI, BRITTANY (MA, QASP-S)
Entity type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:
Last Name:GUCCIARDI
Suffix:
Gender:F
Credentials:MA, QASP-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19019 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3253
Mailing Address - Country:US
Mailing Address - Phone:818-501-8352
Mailing Address - Fax:
Practice Address - Street 1:19019 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3253
Practice Address - Country:US
Practice Address - Phone:805-501-8352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA247200000X106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician