Provider Demographics
NPI:1225805575
Name:PINEDA, KITZIA ANNETE
Entity Type:Individual
Prefix:
First Name:KITZIA
Middle Name:ANNETE
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 1:1651 N RIVERSIDE AVE APT 1225
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-8049
Mailing Address - Country:US
Mailing Address - Phone:909-663-6752
Mailing Address - Fax:
Practice Address - Street 1:1651 N RIVERSIDE AVE APT 1225
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-8049
Practice Address - Country:US
Practice Address - Phone:909-663-6752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst