Healthcare Provider Details

I. General information

NPI: 1740743111
Provider Name (Legal Business Name): INEZ PINEDA MS, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: INEZ ESTELA VILLACORTA

II. Dates (important events)

Enumeration Date: 04/11/2019
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25024 NARBONNE AVE UNIT 5
LOMITA CA
90717-2156
US

IV. Provider business mailing address

11921 ALLARD ST
NORWALK CA
90650-1910
US

V. Phone/Fax

Practice location:
  • Phone: 310-242-0207
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-18-32563
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: