Provider Demographics
NPI:1386702496
Name:PACHECO, DINA YVANIA (MA)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:YVANIA
Last Name:PACHECO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5224 DENNY AVE
Mailing Address - Street 2:115
Mailing Address - City:N HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601
Mailing Address - Country:US
Mailing Address - Phone:213-220-7012
Mailing Address - Fax:
Practice Address - Street 1:8283 GROVE AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730
Practice Address - Country:US
Practice Address - Phone:909-920-9906
Practice Address - Fax:909-920-4151
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist