Healthcare Provider Details

I. General information

NPI: 1508721507
Provider Name (Legal Business Name): ALYSSA M PAREDES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 21ST ST # 1200
BAKERSFIELD CA
93301-4606
US

IV. Provider business mailing address

9717 MESA OAK DR
BAKERSFIELD CA
93311-1604
US

V. Phone/Fax

Practice location:
  • Phone: 805-979-9941
  • Fax:
Mailing address:
  • Phone: 661-304-9108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberY5901593
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: