Provider Demographics
NPI:1538884382
Name:PINEDA, DESIREE ANGELICA
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:ANGELICA
Last Name:PINEDA
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 1:13641 BENTWOOD ST
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92344-0122
Mailing Address - Country:US
Mailing Address - Phone:626-833-2828
Mailing Address - Fax:
Practice Address - Street 1:13641 BENTWOOD ST
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92344-0122
Practice Address - Country:US
Practice Address - Phone:626-833-2828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-04
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
No172V00000XOther Service ProvidersCommunity Health Worker