Provider Demographics
NPI:1487166062
Name:QUITTAN, GIORGIO ANDREA I (LCSW)
Entity type:Individual
Prefix:
First Name:GIORGIO
Middle Name:ANDREA
Last Name:QUITTAN
Suffix:I
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1346 THE ALAMEDA # 7-517
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2699
Mailing Address - Country:US
Mailing Address - Phone:408-888-9060
Mailing Address - Fax:
Practice Address - Street 1:1046 W TAYLOR ST STE 204
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1815
Practice Address - Country:US
Practice Address - Phone:408-888-9060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-03
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA775421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical