Healthcare Provider Details

I. General information

NPI: 1033699319
Provider Name (Legal Business Name): STEPHANIE A PINILLA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2018
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 S LAFAYETTE PARK PLACE 3RD FLOOR
LOS ANGELES CA
90057
US

IV. Provider business mailing address

304 E PLYMOUTH ST
INGLEWOOD CA
90302-2416
US

V. Phone/Fax

Practice location:
  • Phone: 213-252-2100
  • Fax:
Mailing address:
  • Phone: 310-415-4124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberACSW90474
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberACSW90474
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number90474
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberACSW133429
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW140900
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: