Provider Demographics
NPI:1720871940
Name:STORY, BRITTNY (SUDRC #20904)
Entity type:Individual
Prefix:
First Name:BRITTNY
Middle Name:
Last Name:STORY
Suffix:
Gender:F
Credentials:SUDRC #20904
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11555 POSTHILL RD
Mailing Address - Street 2:
Mailing Address - City:LAKESIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92040-1338
Mailing Address - Country:US
Mailing Address - Phone:442-449-7419
Mailing Address - Fax:442-449-7419
Practice Address - Street 1:5473 KEARNY VILLA RD STE 300
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1142
Practice Address - Country:US
Practice Address - Phone:858-298-4024
Practice Address - Fax:858-298-4024
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20904101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)