Healthcare Provider Details

I. General information

NPI: 1215512090
Provider Name (Legal Business Name): MARJORIE PINEDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2021
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date: 09/12/2025
Reactivation Date: 09/01/2026

III. Provider practice location address

24328 VERMONT AVE STE 318
HARBOR CITY CA
90710-2314
US

IV. Provider business mailing address

24328 VERMONT AVE STE 318
HARBOR CITY CA
90710-2314
US

V. Phone/Fax

Practice location:
  • Phone: 424-250-9615
  • Fax:
Mailing address:
  • Phone: 424-250-9615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number27627
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: