Provider Demographics
NPI:1407619554
Name:PINESETT, LAURA-ANN BLACKMER-COELHO
Entity Type:Individual
Prefix:MRS
First Name:LAURA-ANN
Middle Name:BLACKMER-COELHO
Last Name:PINESETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5113 E CARSON ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-1801
Mailing Address - Country:US
Mailing Address - Phone:562-410-1082
Mailing Address - Fax:
Practice Address - Street 1:5113 E CARSON ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-1801
Practice Address - Country:US
Practice Address - Phone:562-410-1082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16805101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)