Healthcare Provider Details

I. General information

NPI: 1457279721
Provider Name (Legal Business Name): JOEL A PAREDES RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E 1ST ST
CASA GRANDE AZ
85122-5202
US

IV. Provider business mailing address

4539 N 22ND ST STE R
PHOENIX AZ
85016-4639
US

V. Phone/Fax

Practice location:
  • Phone: 520-280-8312
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number228299
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: