Provider Demographics
NPI:1881203891
Name:PIRTLE, ATSIE LATONYA
Entity Type:Individual
Prefix:
First Name:ATSIE
Middle Name:LATONYA
Last Name:PIRTLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 ASCOT PKWY APT 2815
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-7013
Mailing Address - Country:US
Mailing Address - Phone:707-563-4450
Mailing Address - Fax:
Practice Address - Street 1:1111 MARKET ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-1509
Practice Address - Country:US
Practice Address - Phone:415-863-3883
Practice Address - Fax:415-863-7343
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-26
Last Update Date:2020-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)