Individual
ANTHONYS STITHZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2000 ASCOT PKWY, VALLEJO, CA 94591-7009
(415) 492-0818
Mailing address
2000 ASCOT PARKWAY, VALLEJO, CA 94591
(415) 492-0818
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B9262196
—
CA
Enumeration date
09/14/2015
Last updated
09/14/2015
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