Individual
DESTINY DEJA PITTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1775 CHESTNUT AVE, LONG BEACH, CA 90813-1674
(562) 599-8444
Mailing address
1776 N STANTON PL APT 2, LONG BEACH, CA 90804-7892
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
710627
CA
Other
Enumeration date
04/27/2020
Last updated
04/27/2020
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