Provider Demographics
NPI:1336541630
Name:PINEDA, SANDRA JANET (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:JANET
Last Name:PINEDA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4852 W 111TH ST
Mailing Address - Street 2:
Mailing Address - City:LENNOX
Mailing Address - State:CA
Mailing Address - Zip Code:90304-2133
Mailing Address - Country:US
Mailing Address - Phone:310-909-3923
Mailing Address - Fax:
Practice Address - Street 1:604 ROSE AVE
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:CA
Practice Address - Zip Code:90291-2767
Practice Address - Country:US
Practice Address - Phone:310-664-7756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69204183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist