Provider Demographics
NPI:1194586958
Name:PINEDA, ZULMA PATRICIA
Entity type:Individual
Prefix:
First Name:ZULMA
Middle Name:PATRICIA
Last Name:PINEDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12175 13TH ST APT 38
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-1868
Mailing Address - Country:US
Mailing Address - Phone:951-378-1434
Mailing Address - Fax:
Practice Address - Street 1:12175 13TH ST APT 38
Practice Address - Street 2:
Practice Address - City:YUCAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399-1868
Practice Address - Country:US
Practice Address - Phone:951-378-1434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician