Provider Demographics
NPI:1033481858
Name:PIMENTEL, KARLA M
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:M
Last Name:PIMENTEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 ANGELINA
Mailing Address - Street 2:
Mailing Address - City:CHAPARRAL
Mailing Address - State:NM
Mailing Address - Zip Code:88081-7558
Mailing Address - Country:US
Mailing Address - Phone:915-355-0497
Mailing Address - Fax:
Practice Address - Street 1:229 ANGELINA
Practice Address - Street 2:
Practice Address - City:CHAPARRAL
Practice Address - State:NM
Practice Address - Zip Code:88081-7558
Practice Address - Country:US
Practice Address - Phone:915-355-0497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health