Provider Demographics
NPI:1164007977
Name:PINEDA, NATALIE ALIYAH
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ALIYAH
Last Name:PINEDA
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 1:2055 CENTRAL AVE APT 6K
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-7405
Mailing Address - Country:US
Mailing Address - Phone:909-894-9466
Mailing Address - Fax:
Practice Address - Street 1:2055 CENTRAL AVE APT 6K
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-7405
Practice Address - Country:US
Practice Address - Phone:909-894-9466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty