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General NPI Number Information
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NPI Number | 1336843283
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Entity Type | Organization
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Legal Business Name | MANDISA PITTMON LMFT MARRIAGE AND FAMILY THERAPIST INC
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Dates
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Enumeration Date | 03/27/2023
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Last Update Date | 03/27/2023
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Provider Practice Location Address
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Address Line | 3960 INDUSTRIAL BLVD STE 200
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City | WEST SACRAMENTO
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State | CA
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Zip | 95691-5024
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Country | US
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Telephone | 916-584-9395
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Fax | 310-602-6721
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Provider Business Mailing Address
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Address Line | PO BOX 340628
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City | SACRAMENTO
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State | CA
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Zip | 95834-0628
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | MANDISA PITTMON STEPTER
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Credential | LMFT
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Telephone | 310-847-9271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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