Healthcare Provider Details

I. General information

NPI: 1972831824
Provider Name (Legal Business Name): MEGAN KATRINA PITSIOS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEGAN KATRINA PITSIOS M.S.W.

II. Dates (important events)

Enumeration Date: 12/03/2009
Last Update Date: 05/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3827 E COLORADO BLVD
PASADENA CA
91107-3935
US

IV. Provider business mailing address

3827 E COLORADO BLVD
PASADENA CA
91107-3935
US

V. Phone/Fax

Practice location:
  • Phone: 626-727-8462
  • Fax:
Mailing address:
  • Phone: 626-727-8462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW31654
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW 31654
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: