Provider Demographics
NPI:1578915708
Name:PITTS, ANTHONY (RADT-I)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:
Last Name:PITTS
Suffix:
Gender:M
Credentials:RADT-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 WRIGHT ST APT 8
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-1172
Mailing Address - Country:US
Mailing Address - Phone:916-922-9217
Mailing Address - Fax:916-921-1128
Practice Address - Street 1:2143 HURLEY WAY
Practice Address - Street 2:STE 250
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-3253
Practice Address - Country:US
Practice Address - Phone:916-922-9217
Practice Address - Fax:916-921-1128
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1233950716101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)