Provider Demographics
NPI:1639672926
Name:GALEAZZI-PIMENTEL, JOLEEN NICOLE
Entity Type:Individual
Prefix:
First Name:JOLEEN
Middle Name:NICOLE
Last Name:GALEAZZI-PIMENTEL
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 1:15589 LA MOINE ST
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-5903
Mailing Address - Country:US
Mailing Address - Phone:626-808-5522
Mailing Address - Fax:
Practice Address - Street 1:5885 HAVEN AVE
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91737-3002
Practice Address - Country:US
Practice Address - Phone:626-808-5522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer