Individual
ANNELIESE PETITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
474 W VERMONT AVE STE 104, ESCONDIDO, CA 92025-6584
(760) 432-9884
(760) 888-2136
Mailing address
9465 FARNHAM ST, SAN DIEGO, CA 92123-1308
(858) 573-2600
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/10/2025
Last updated
08/27/2025
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