Individual
TARA NICOLE PITTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 S TUSTIN STREET, BUILDING C, ORANGE, CA 92866-2550
(714) 361-4860
(714) 361-4861
Mailing address
401 S TUSTIN ST BLDG C, ORANGE, CA 92866-2550
(714) 361-4860
(714) 361-4861
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/15/2018
Last updated
10/15/2018
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