Healthcare Provider Details

I. General information

NPI: 1508905191
Provider Name (Legal Business Name): BETZAIDA PINEDO R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BECKY PINEDO

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4510 N 37TH AVE
PHOENIX AZ
85019-3206
US

IV. Provider business mailing address

2637 N 64TH DR
PHOENIX AZ
85035-1528
US

V. Phone/Fax

Practice location:
  • Phone: 602-242-0281
  • Fax: 602-242-2791
Mailing address:
  • Phone: 602-242-0281
  • Fax: 602-242-2791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN116229
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: