Provider Demographics
NPI:1023617800
Name:PINA, LAUREN ASHLEI (LCSW)
Entity type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:ASHLEI
Last Name:PINA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39199 LIBERTY ST BLDG B
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1501
Mailing Address - Country:US
Mailing Address - Phone:510-791-4000
Mailing Address - Fax:
Practice Address - Street 1:39119 LIBERTY STREET
Practice Address - Street 2:BUILDING B ROOM 118 FRE-122-SW
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1510
Practice Address - Country:US
Practice Address - Phone:510-791-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-22
Last Update Date:2024-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1218361041C0700X
SC1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical