=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770917130
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MS. ERIN LYNN WITTA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/21/2013
-----------------------------------------------------
Last Update Date | 11/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 700 AIRPORT BLVD STE AND495
-----------------------------------------------------
City | BURLINGAME
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94010-1908
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-517-8220
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3660 MADRONE AVE
-----------------------------------------------------
City | OAKLAND
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94619-2706
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-407-0208
-----------------------------------------------------
Fax | 415-407-0208
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 111715
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------