Provider Demographics
NPI:1639382617
Name:PINEDA, ASTRID CORPUS (NP)
Entity Type:Individual
Prefix:MRS
First Name:ASTRID
Middle Name:CORPUS
Last Name:PINEDA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ASTRID
Other - Middle Name:HERNANDO
Other - Last Name:CORPUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:7515 VAN NUYS BLVD
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405
Mailing Address - Country:US
Mailing Address - Phone:818-947-4026
Mailing Address - Fax:818-947-4610
Practice Address - Street 1:7515 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405
Practice Address - Country:US
Practice Address - Phone:818-947-4026
Practice Address - Fax:818-947-4610
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16724163W00000X
CANP16724363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse