Provider Demographics
NPI:1093030694
Name:PINEDA, EMILIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:EMILIA
Middle Name:
Last Name:PINEDA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:EMILIA
Other - Middle Name:P
Other - Last Name:WEGESSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:200 S. WELLS RD., SUITE 200
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93004-1302
Mailing Address - Country:US
Mailing Address - Phone:805-659-1740
Mailing Address - Fax:805-659-3217
Practice Address - Street 1:200 S. WELLS RD., SUITE 250
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93004
Practice Address - Country:US
Practice Address - Phone:805-659-1740
Practice Address - Fax:805-659-3217
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 269461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical