Provider Demographics
NPI:1003053281
Name:PINEDA, YVONNE DENISE (CST CFA)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:DENISE
Last Name:PINEDA
Suffix:
Gender:F
Credentials:CST CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:76082-7180
Mailing Address - Country:US
Mailing Address - Phone:316-371-2623
Mailing Address - Fax:
Practice Address - Street 1:1105 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:SPRINGTOWN
Practice Address - State:TX
Practice Address - Zip Code:76082-7180
Practice Address - Country:US
Practice Address - Phone:316-371-2623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist