Provider Demographics
NPI:1972376291
Name:SITISO, NITIGRON PILLER (DPT)
Entity type:Individual
Prefix:
First Name:NITIGRON
Middle Name:PILLER
Last Name:SITISO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14078 HOYT ST
Mailing Address - Street 2:
Mailing Address - City:ARLETA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-5215
Mailing Address - Country:US
Mailing Address - Phone:818-723-5103
Mailing Address - Fax:
Practice Address - Street 1:14078 HOYT ST
Practice Address - Street 2:
Practice Address - City:ARLETA
Practice Address - State:CA
Practice Address - Zip Code:91331-5215
Practice Address - Country:US
Practice Address - Phone:818-723-5103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA304533225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist