Provider Demographics
NPI:1285392381
Name:ROSS, BRIANNE JOHANNA-LOPICCOLO (FNP)
Entity type:Individual
Prefix:
First Name:BRIANNE
Middle Name:JOHANNA-LOPICCOLO
Last Name:ROSS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15251 NATIONAL AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2400
Mailing Address - Country:US
Mailing Address - Phone:408-358-7360
Mailing Address - Fax:408-358-7357
Practice Address - Street 1:15251 NATIONAL AVE STE 104
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2400
Practice Address - Country:US
Practice Address - Phone:408-358-7360
Practice Address - Fax:408-358-7357
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95019327363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily