Provider Demographics
NPI:1184726473
Name:PITTMAN, STEVEN GARY (PHD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:GARY
Last Name:PITTMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9330 CARMEL MOUNTAIN ROAD
Mailing Address - Street 2:SUITE F
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129
Mailing Address - Country:US
Mailing Address - Phone:858-780-9927
Mailing Address - Fax:858-780-9953
Practice Address - Street 1:9330 CARMEL MOUNTAIN RD
Practice Address - Street 2:SUITE F
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-2157
Practice Address - Country:US
Practice Address - Phone:858-780-9927
Practice Address - Fax:858-780-9953
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 9318103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical