MEDICARE: MISS ANA PILAR PETITTE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCSW135675	CA

General Provider Information

NPI Number	:	1043332174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ANA PILAR PETITTE LCSW

Provider Business Mailing Address
First Line	:	PO BOX 23217
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92193-3217
Country	:	US
Telephone Number	:	619-792-3450
Fax Number	:

Provider Business Practice Location Address
First Line	:	389 N MAGNOLIA AVE
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-3977
Country	:	US
Telephone Number	:	858-505-6704
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	01/21/2026

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