Provider Demographics
NPI:1588216030
Name:PINEDA RIVAS, NATALIA
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:PINEDA RIVAS
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 1:7038 VESPER AVE APT 104
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-3084
Mailing Address - Country:US
Mailing Address - Phone:323-404-4547
Mailing Address - Fax:
Practice Address - Street 1:5352 LAUREL CANYON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91607-4923
Practice Address - Country:US
Practice Address - Phone:747-254-1154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician