Provider Demographics
NPI:1053110239
Name:LA ROSA, BRITTANY LAUREN (RD)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LAUREN
Last Name:LA ROSA
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8712 LOFTUS DR
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-1812
Mailing Address - Country:US
Mailing Address - Phone:626-422-5580
Mailing Address - Fax:
Practice Address - Street 1:8712 LOFTUS DR
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-1812
Practice Address - Country:US
Practice Address - Phone:626-422-5580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86101020133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered