Healthcare Provider Details

I. General information

NPI: 1083546311
Provider Name (Legal Business Name): PINERIDGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 FOOTHILL BLVD STE 102
LA CRESCENTA CA
91214-3574
US

IV. Provider business mailing address

2626 FOOTHILL BLVD STE 102
LA CRESCENTA CA
91214-3574
US

V. Phone/Fax

Practice location:
  • Phone: 818-468-3907
  • Fax:
Mailing address:
  • Phone: 818-468-3907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MOSES JOOHARIAN
Title or Position: OWNER
Credential:
Phone: 818-468-3907