Provider Demographics
NPI:1841426855
Name:LITZ, PIA CRISTINA (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:PIA
Middle Name:CRISTINA
Last Name:LITZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1486 HUNTINGTON AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-5970
Mailing Address - Country:US
Mailing Address - Phone:650-877-8642
Mailing Address - Fax:
Practice Address - Street 1:1486 HUNTINGTON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-5970
Practice Address - Country:US
Practice Address - Phone:650-877-8642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-04
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJL47306306361836390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA390200000XOtherSTUDENTS, HEALTH CARE