Healthcare Provider Details

I. General information

NPI: 1013684612
Provider Name (Legal Business Name): DANIELLA MAXINE PINEDO KARDOS BA, MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2021
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W. SANTA ANA BLVD SUITE 600
SANTA ANA CA
92701
US

IV. Provider business mailing address

600 W SANTA ANA BLVD SUITE 600
SANTA ANA CA
92701-5017
US

V. Phone/Fax

Practice location:
  • Phone: 714-953-4455
  • Fax:
Mailing address:
  • Phone: 714-953-4455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number111934
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: