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NPI Code Detail

MEDICARE: JUSTIN PEWITT

MEDICARE: JUSTIN PEWITT
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
1101YA0400XAddiction (Substance Use Disorder) CounselorR1576130824

General Provider Information

NPI Number : 1942347133
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN PEWITT
Provider Business Mailing Address
First Line : 107 E MICHELTORENA ST
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93101-1905
Country : US
Telephone Number : 805-965-3434
Fax Number :
Provider Business Practice Location Address
First Line : 1147 HARTNELL AVE
Second Line :
City : REDDING
State : CA
Zip : 96002-2113
Country : US
Telephone Number : 530-222-7213
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2007
Last Update Date : 09/17/2024

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Directions to “ JUSTIN PEWITT ” Practice Location

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