Provider Demographics
NPI:1851836324
Name:PINEDA, ISRAEL
Entity Type:Individual
Prefix:MR
First Name:ISRAEL
Middle Name:
Last Name:PINEDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83446 TODOS SANTOS
Mailing Address - Street 2:
Mailing Address - City:COACHELLA
Mailing Address - State:CA
Mailing Address - Zip Code:92236-6392
Mailing Address - Country:US
Mailing Address - Phone:760-625-5811
Mailing Address - Fax:
Practice Address - Street 1:49869 CALHOUN ST STE D
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-9720
Practice Address - Country:US
Practice Address - Phone:760-398-9090
Practice Address - Fax:760-398-9790
Is Sole Proprietor?:No
Enumeration Date:2016-12-19
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA135126106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist