Provider Demographics
NPI:1558184440
Name:PINNEY, CRYSTAL STELLA (OTD, MSOT)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:STELLA
Last Name:PINNEY
Suffix:
Gender:F
Credentials:OTD, MSOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 STATE ST APT 4
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-2130
Mailing Address - Country:US
Mailing Address - Phone:626-676-5133
Mailing Address - Fax:
Practice Address - Street 1:1118 N STONEMAN AVE
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-1007
Practice Address - Country:US
Practice Address - Phone:626-308-9777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24860225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist