Provider Demographics
NPI:1891141800
Name:BITZ, BRIANNA CHERI
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:CHERI
Last Name:BITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRI
Other - Middle Name:
Other - Last Name:BITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:126 W.25TH AVENUE., SUITE 200
Mailing Address - Street 2:APT 8
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-2562
Mailing Address - Country:US
Mailing Address - Phone:510-482-2244
Mailing Address - Fax:
Practice Address - Street 1:126 W 25TH AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-2208
Practice Address - Country:US
Practice Address - Phone:510-482-2244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-09
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health