Healthcare Provider Details

I. General information

NPI: 1629108139
Provider Name (Legal Business Name): DIANA E PINEDA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DIANA E CAMELLO LCSW

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23701 MAIN ST
CARSON CA
90745-5745
US

IV. Provider business mailing address

23701 MAIN ST
CARSON CA
90745-5745
US

V. Phone/Fax

Practice location:
  • Phone: 310-816-5447
  • Fax:
Mailing address:
  • Phone: 310-816-5447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number70212
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: