Healthcare Provider Details

I. General information

NPI: 1588803902
Provider Name (Legal Business Name): ANELYN PIMENTEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2009
Last Update Date: 02/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 CARMEN LN SUITE 201
SANTA MARIA CA
93458-7769
US

IV. Provider business mailing address

133 ARROYO LANE
SANTA MARIA CA
93454
US

V. Phone/Fax

Practice location:
  • Phone: 805-739-8706
  • Fax: 805-928-1146
Mailing address:
  • Phone: 805-739-8706
  • Fax: 805-739-8737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: