Provider Demographics
NPI:1063306165
Name:PIZZUTILLO, ANTHONY RYAN (APCC)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:RYAN
Last Name:PIZZUTILLO
Suffix:
Gender:M
Credentials:APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2915 IRVING ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-1413
Mailing Address - Country:US
Mailing Address - Phone:802-488-4326
Mailing Address - Fax:
Practice Address - Street 1:2915 IRVING ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-1413
Practice Address - Country:US
Practice Address - Phone:802-488-4326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17485101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health