Provider Demographics
NPI:1164034070
Name:PINEDA, GABRIELA (AMFT)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:PINEDA
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90018-4202
Mailing Address - Country:US
Mailing Address - Phone:323-412-1356
Mailing Address - Fax:
Practice Address - Street 1:540 N GOLDEN CIRCLE DR STE 312
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3926
Practice Address - Country:US
Practice Address - Phone:714-332-1205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114295106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist