Provider Demographics
NPI:1346039864
Name:PINEDA, BETSY
Entity type:Individual
Prefix:
First Name:BETSY
Middle Name:
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 1:4527 JOHN SMITH RD
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-9711
Mailing Address - Country:US
Mailing Address - Phone:831-245-5948
Mailing Address - Fax:
Practice Address - Street 1:4527 JOHN SMITH RD
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-9711
Practice Address - Country:US
Practice Address - Phone:831-245-5948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician