Provider Demographics
NPI:1588440689
Name:PINEDO, KAYLA ALEJANDRA
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:ALEJANDRA
Last Name:PINEDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-2842
Mailing Address - Country:US
Mailing Address - Phone:559-598-2979
Mailing Address - Fax:
Practice Address - Street 1:1610 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-2842
Practice Address - Country:US
Practice Address - Phone:559-598-2979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician