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Individual

ALYSSA MARIAH PITAMBAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3620 W HAMMER LN, STOCKTON, CA 95219-5435
(209) 521-4791
Mailing address
197 GINO LUCA ST, MANTECA, CA 95337-2019
(209) 229-3350

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Enumeration date
08/08/2021
Last updated
08/08/2021
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