Basic Information
| Provider Information | |||||||||
| NPI: | 1104964287 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PINEDA | ||||||||
| FirstName: | DOLORES | ||||||||
| MiddleName: | ELENA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2201 SUTTER ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941153109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4152937362 | ||||||||
| FaxNumber: | 4157761066 | ||||||||
| Practice Location | |||||||||
| Address1: | 211 13TH STRRET | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941153109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4157761001 | ||||||||
| FaxNumber: | 4157761066 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2007 | ||||||||
| LastUpdateDate: | 04/11/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health | 171M00000X | N | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.