Provider Demographics
NPI:1437261765
Name:PFITZER, PAMELA (MFT)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:PFITZER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 SUNRISE AVE
Mailing Address - Street 2:SUITE 160
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4523
Mailing Address - Country:US
Mailing Address - Phone:916-781-3402
Mailing Address - Fax:916-781-2632
Practice Address - Street 1:775 SUNRISE AVE
Practice Address - Street 2:SUITE 160
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4523
Practice Address - Country:US
Practice Address - Phone:916-781-3402
Practice Address - Fax:916-781-2632
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAM16539106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist