Provider Demographics
NPI:1699071563
Name:PINNAVAIA, LOREE (DC)
Entity type:Individual
Prefix:DR
First Name:LOREE
Middle Name:
Last Name:PINNAVAIA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16400 LARK AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2547
Mailing Address - Country:US
Mailing Address - Phone:408-358-1760
Mailing Address - Fax:408-358-1764
Practice Address - Street 1:16400 LARK AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2547
Practice Address - Country:US
Practice Address - Phone:408-358-1760
Practice Address - Fax:408-358-1764
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22124111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic