Healthcare Provider Details

I. General information

NPI: 1205310117
Provider Name (Legal Business Name): CHRISTINA PINEDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2018
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9465 FARNHAM ST
SAN DIEGO CA
92123-1308
US

IV. Provider business mailing address

9465 FARNHAM ST
SAN DIEGO CA
92123-1308
US

V. Phone/Fax

Practice location:
  • Phone: 858-388-9685
  • Fax:
Mailing address:
  • Phone: 858-388-9685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number163978
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: