Provider Demographics
NPI:1164519567
Name:PITTS, CHERYL ANN (LCSW, BCD)
Entity Type:Individual
Prefix:MISS
First Name:CHERYL
Middle Name:ANN
Last Name:PITTS
Suffix:
Gender:F
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7111
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92607-7111
Mailing Address - Country:US
Mailing Address - Phone:949-425-8700
Mailing Address - Fax:949-495-7686
Practice Address - Street 1:30131 TOWN CENTER DR
Practice Address - Street 2:SUITE 280
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-2034
Practice Address - Country:US
Practice Address - Phone:949-425-8700
Practice Address - Fax:949-495-7686
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS117011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical