Healthcare Provider Details

I. General information

NPI: 1053267914
Provider Name (Legal Business Name): JOANNA PELINO
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 CAROB ST
OXNARD CA
93035-3334
US

IV. Provider business mailing address

4561 VIA RODEO
NEWBURY PARK CA
91320-6744
US

V. Phone/Fax

Practice location:
  • Phone: 805-385-1554
  • Fax:
Mailing address:
  • Phone: 828-521-7381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: