Provider Demographics
NPI:1942327820
Name:PINTADO, EMMA OLIVIA (LVN)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:OLIVIA
Last Name:PINTADO
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442 CRESTGLEN RD
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-2169
Mailing Address - Country:US
Mailing Address - Phone:626-437-0171
Mailing Address - Fax:
Practice Address - Street 1:18612 SANTA ANA AVE
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:CA
Practice Address - Zip Code:92316-2636
Practice Address - Country:US
Practice Address - Phone:909-421-7120
Practice Address - Fax:909-421-7128
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN196410164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse