Provider Demographics
NPI:1265238042
Name:PINEDA, KAMALANI DAMARIS
Entity type:Individual
Prefix:
First Name:KAMALANI
Middle Name:DAMARIS
Last Name:PINEDA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1834 PEPPER TREE LN
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-4950
Mailing Address - Country:US
Mailing Address - Phone:909-936-7496
Mailing Address - Fax:
Practice Address - Street 1:1834 PEPPER TREE LN
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-4950
Practice Address - Country:US
Practice Address - Phone:909-936-7496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical