Provider Demographics
NPI:1285445676
Name:PIMENTEL, ELIZABETH ACEVEDO (MS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ACEVEDO
Last Name:PIMENTEL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:ACEVEDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:3036 THOMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:CA
Mailing Address - Zip Code:93662-2433
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3036 THOMPSON AVE
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:CA
Practice Address - Zip Code:93662-2433
Practice Address - Country:US
Practice Address - Phone:559-691-2936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool