Provider Demographics
NPI:1730548389
Name:PITTY, NUVIA
Entity type:Individual
Prefix:
First Name:NUVIA
Middle Name:
Last Name:PITTY
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 1:34888 11TH ST APT 534
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-8550
Mailing Address - Country:US
Mailing Address - Phone:510-857-4537
Mailing Address - Fax:
Practice Address - Street 1:34888 11TH ST APT 534
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-8550
Practice Address - Country:US
Practice Address - Phone:510-857-4537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD7149521251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health