Healthcare Provider Details

I. General information

NPI: 1871421834
Provider Name (Legal Business Name): JESSICA PINEDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E VALENCIA MESA DR
FULLERTON CA
92835-3809
US

IV. Provider business mailing address

6842 SAN PASQUAL CIR
BUENA PARK CA
90620-3027
US

V. Phone/Fax

Practice location:
  • Phone: 714-871-3280
  • Fax:
Mailing address:
  • Phone: 562-686-9597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW118952
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: