Provider Demographics
NPI:1598541880
Name:PINKNEY, DESIREE DANIEL (LMT)
Entity Type:Individual
Prefix:MISS
First Name:DESIREE
Middle Name:DANIEL
Last Name:PINKNEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9442 PARK ST
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-5764
Mailing Address - Country:US
Mailing Address - Phone:714-366-5640
Mailing Address - Fax:
Practice Address - Street 1:10050 ROSECRANS AVE
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-2562
Practice Address - Country:US
Practice Address - Phone:562-565-4039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA92807225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist