Healthcare Provider Details

I. General information

NPI: 1780924241
Provider Name (Legal Business Name): JACQUELINE CAROL PINHO HFS, E-RYT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2013
Last Update Date: 02/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3281 E CEDAR DR
CHANDLER AZ
85249-4509
US

IV. Provider business mailing address

12829 E CHANDLER HEIGHTS RD
CHANDLER AZ
85249-3101
US

V. Phone/Fax

Practice location:
  • Phone: 602-751-7023
  • Fax:
Mailing address:
  • Phone: 602-743-8748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: