Provider Demographics
NPI:1710282595
Name:PITTMAN, CEDRIC DELEON (MPA)
Entity Type:Individual
Prefix:MR
First Name:CEDRIC
Middle Name:DELEON
Last Name:PITTMAN
Suffix:
Gender:M
Credentials:MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 W. CHEYENNE AVE.
Mailing Address - Street 2:SUITE 400
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032
Mailing Address - Country:US
Mailing Address - Phone:702-631-0230
Mailing Address - Fax:702-631-0809
Practice Address - Street 1:3450 W. CHEYENNE AVE.
Practice Address - Street 2:SUITE 400
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032
Practice Address - Country:US
Practice Address - Phone:702-631-0230
Practice Address - Fax:702-631-0809
Is Sole Proprietor?:No
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst