Active NPI
Jennifer Pineda
- Behavior Technician
- Los Angeles, CA
National Provider Identifier
1104528512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 12021 Wilmington Ave BLDG 18
Los Angeles, CA 90059-3019 - Phone
- (424) 454-5530
- NPI assigned
- Mar 20, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Psychiatric Technician | 167G00000X | 42839 | CA | |
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
12021 Wilmington Ave BLDG 18
Los Angeles, CA 90059-3019
Mailing address
1832 W Commonwealth Ave Unit 109
Fullerton, CA 92833-3048
Phone (714) 583-2806
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42839 | CA | MD | Licensed Psychiatric Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761696000000",
"number": "1104528512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1832 W COMMONWEALTH AVE UNIT 109",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928333048",
"telephone_number": "714-583-2806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12021 WILMINGTON AVE BLDG 18",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900593019",
"telephone_number": "424-454-5530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PINEDA",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-20",
"last_updated": "2025-10-29",
"certification_date": "2025-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "167G00000X",
"taxonomy_group": "",
"desc": "Licensed Psychiatric Technician",
"state": "CA",
"license": "42839",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.