MEDICARE: MR. CIPRIANO EDWARD PINKNEY BA SOCIAL WORK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	171M00000X	Case Manager/Care Coordinator
2	225C00000X	Rehabilitation Counselor
3	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1235205782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CIPRIANO EDWARD PINKNEY BA SOCIAL WORK

Provider Business Mailing Address
First Line	:	679 S NEW HAMPSHIRE AVE
Second Line	:	400
City	:	LOS ANGELES
State	:	CA
Zip	:	90005-1355
Country	:	US
Telephone Number	:	213-639-0251
Fax Number	:

Provider Business Practice Location Address
First Line	:	679 S NEW HAMPSHIRE AVE
Second Line	:	400
City	:	LOS ANGELES
State	:	CA
Zip	:	90005-1355
Country	:	US
Telephone Number	:	213-639-0251
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2006
Last Update Date	:	05/02/2017

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