Individual
JACQUELINE L PITTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1895 MOWRY AVE, SUITE 116, FREMONT, CA 94538-1737
(510) 792-3398
(510) 792-3951
Mailing address
1834 STONE AVE, SUITE 2B, SAN JOSE, CA 95125-1306
(408) 995-0102
(408) 995-0190
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN395303
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN3953030
—
CA
Enumeration date
10/17/2006
Last updated
07/09/2007
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