Provider Demographics
NPI:1053960377
Name:PICHARDO, MARIANA VIANEY
Entity type:Individual
Prefix:
First Name:MARIANA
Middle Name:VIANEY
Last Name:PICHARDO
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 1:444 E HUNTINGTON DR STE 103
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-6257
Mailing Address - Country:US
Mailing Address - Phone:626-671-8866
Mailing Address - Fax:
Practice Address - Street 1:444 E HUNTINGTON DR STE 103
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-6257
Practice Address - Country:US
Practice Address - Phone:626-671-8866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst