Brittany Lang Bongga, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95004741 Issued in CA

Practice address

17051 Sierra Lakes Pkwy Ste 101
Fontana, CA 92336-1274

Phone

(909) 428-2040

Fax

(909) 428-2191

NPI assigned

Sep 1, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Meza Consulting LLC

  • Family Medicine Physician
  • Coeur D Alene, ID
  • NPI 1861867426
  NPD
• Meza Post Acute and Long Term Care, PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Coeur D Alene, ID
  • NPI 1932725215
  NPD
• Sound Physicians of Idaho

  • Hospitalist Physician
  • Lewiston, ID
  • NPI 1730407461
  NPD
• South Sound Inpatient Physicians PLLC

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1023285756
  NPD
• South Sound Inpatient Physicians PLLC

  • Internal Medicine Physician
  • Hillsboro, OR
  • NPI 1508023789
  NPD
• South Sound Inpatient Physicians, PLLC

  • Internal Medicine Physician
  • Burien, WA
  • NPI 1366741290
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1902353451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "address_2": "CREDENTIALING DEPARTMENT",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17051 SIERRA LAKES PKWY STE 101",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361274",
            "telephone_number": "909-428-2040",
            "fax_number": "909-428-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONGGA",
        "first_name": "BRITTANY",
        "middle_name": "LANG",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95004741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Bodzio, PA-C
• Brian Boeck, PH.D, BCBA
• Boehm Dental Specialists PC
• Sara Boghosian, FNP-C
• Lauren Elaina-Emad Bolous
• Judith Anallely Bonilla Lopez
• Brianna Bonilla
• Sharon Bonilla
• Desiree Cherie Borden, PHARM.D.
• Inelda Borg, OTR

• Family Nurse Practitioner in Fontana, CA
• Providers in Fontana, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.