Provider Demographics
NPI:1568354082
Name:DA COSTA PINTO, JENNIFER MARIA (CMI)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIA
Last Name:DA COSTA PINTO
Suffix:
Gender:F
Credentials:CMI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10005 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:76227-5429
Mailing Address - Country:US
Mailing Address - Phone:651-702-2673
Mailing Address - Fax:
Practice Address - Street 1:10005 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:PROVIDENCE VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:76227-5429
Practice Address - Country:US
Practice Address - Phone:651-702-2673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty