Provider Demographics
NPI:1922543834
Name:PITT, CHERYL (PHARM D)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:PITT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29676 RANCHO CALIFORNIA RD
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-5283
Mailing Address - Country:US
Mailing Address - Phone:951-693-2704
Mailing Address - Fax:951-294-5774
Practice Address - Street 1:29676 RANCHO CALIFORNIA RD
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-5283
Practice Address - Country:US
Practice Address - Phone:951-693-2704
Practice Address - Fax:951-294-5774
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-31
Last Update Date:2016-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51758183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist