Provider Demographics
NPI:1689897597
Name:PITTS, JOEL EARL (MFC 50643)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:EARL
Last Name:PITTS
Suffix:
Gender:M
Credentials:MFC 50643
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 MARKET ST
Mailing Address - Street 2:15TH FLOOR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94105-2422
Mailing Address - Country:US
Mailing Address - Phone:800-548-6549
Mailing Address - Fax:
Practice Address - Street 1:425 MARKET ST
Practice Address - Street 2:15TH FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-2422
Practice Address - Country:US
Practice Address - Phone:800-548-6549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 50643106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist