Provider Demographics
NPI:1558512699
Name:PITZER, SALLY (WHNP)
Entity Type:Individual
Prefix:MS
First Name:SALLY
Middle Name:
Last Name:PITZER
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 HILLMONT AVE
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-1651
Mailing Address - Country:US
Mailing Address - Phone:805-233-7746
Mailing Address - Fax:805-643-0712
Practice Address - Street 1:350 HILLMONT AVE
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-1651
Practice Address - Country:US
Practice Address - Phone:805-233-7746
Practice Address - Fax:805-643-0712
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4896363LF0000X
CA401381364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily