Provider Demographics
NPI:1205997111
Name:PITTMAN, MARIA HO (SR PT)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:HO
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:SR PT
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:HO
Other - Last Name:PITTMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:1001 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-5134
Mailing Address - Country:US
Mailing Address - Phone:916-746-4659
Mailing Address - Fax:
Practice Address - Street 1:1001 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-5134
Practice Address - Country:US
Practice Address - Phone:916-746-4659
Practice Address - Fax:916-746-4420
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 9840171100000X
CAPT 15919225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist