Provider Demographics
NPI:1922370931
Name:PIZZIO, MARCIA M
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:M
Last Name:PIZZIO
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 1:3133 GILMORE ST
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-5501
Mailing Address - Country:US
Mailing Address - Phone:530-626-0259
Mailing Address - Fax:
Practice Address - Street 1:6765 GREEN VALLEY RD
Practice Address - Street 2:SUITE #F
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-8984
Practice Address - Country:US
Practice Address - Phone:530-622-5551
Practice Address - Fax:530-622-5800
Is Sole Proprietor?:No
Enumeration Date:2012-02-07
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARAS P1203232213174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP1203232213OtherRAS ALCOHOL AND DRUG COUNSELOR